RESUMO
OBJECTIVE: To evaluate patient-reported outcomes (PROs) between women treated by laparoscopic, robotic and open approaches for endometrial cancer. METHODS: Prospective cohort study comparing PRO at baseline, short- (1 and 3â¯weeks) and long-term (12 and 24â¯weeks) follow-up postoperatively. Quality of life (QOL) measures were the Functional Assessment of Cancer Therapy (FACT-G), EuroQol Five Dimensions (EQ-5D), and Brief Pain Inventory (BPI). Sexual health measures were the Female Sexual Function Index (FSFI) and the Sexual Adjustment and Body Image Scale for Gynecologic Cancer (SABIS-G). RESULTS: 468 eligible patients (laparotomyâ¯=â¯92, laparoscopyâ¯=â¯152, roboticâ¯=â¯224) were recruited. There were no significant differences between the laparoscopy and robotic groups for any PRO (Pâ¯>â¯0.05). At short-term follow-up, patients who underwent minimally invasive surgery (robotic or laparoscopy) had significantly higher FACT-G (Pâ¯<â¯0.0001) and EQ-5D (Pâ¯<â¯0.0001) scores, with less pain (Pâ¯=â¯0.02) and improved pain interference (Pâ¯=â¯0.0008), than patients undergoing laparotomy. At long-term follow-up, there were sustained improvements in the FACT-G (Pâ¯=â¯0.035) and the health state EQ-5D visual analogue scale (Pâ¯=â¯0.022). Surgical approach had no impact on sexual health (Pâ¯>â¯0.05); however the mean FSFI score for the entire cohort met clinical cut-offs for sexual dysfunction. CONCLUSION: Minimally invasive approaches result in improved QOL beyond the short-term postoperative period, with benefits noted up to 12â¯weeks after surgery. This prolonged QOL advantage provides further evidence that MIS should be the standard surgical approach for women with early stage endometrial cancer.