Same-day discharge in endometrial cancer surgery: current evidence and future directions

Endometrial cancer, one of the most common gynecologic malignancies, is increasingly associated with obesity and an aging population. Our semi-systematic review evaluated the current evidence on same-day discharge (SDD) following endometrial cancer surgery and conducted a bibliometric analysis. A PubMed search (January 2025) identified 11 studies, including 44,230 patients, predominantly from high-income countries, with 81.8% undergoing minimally invasive surgery and 14.5% sentinel lymph node mapping. No mortalities were reported, and readmission rates ranged from 1.5% to 3.4%. Our findings suggest that SDD is a feasible and safe approach, particularly in North America and for minimally invasive procedures. However, research gaps remain regarding implementation in low- and middle-income countries and in populations with severe obesity or advanced age. Future studies should emphasize standardized reporting, patient selection criteria, and comparative analyses across healthcare systems.

Robotic surgery; Laparoscopy; Endometrial cancer; Minimally invasive surgery; Single day discharge; Same day discharge

[1] Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2024; 74: 229–263.

[2] Bilir E, Kahramanoglu I. The role of hysteroscopy in fertility preservation in endometrial cancer and atypical endometrial hyperplasia: a semi-systematic literature review. Archives of Gynecology and Obstetrics. 2023; 308: 1113–1126.

[3] Bilir E, Kacperczyk-Bartnik J, Bizzarri N, Kahramanoğlu İ. Current practice with operative hysteroscopy for fertility preservation in endometrial cancer and endometrial premalignancies. Archives of Gynecology and Obstetrics. 2024; 309: 2267–2278.

[4] Bulutay P, Bilir E, Yıldız Ş, Ata B. Epidermal growth factor receptor-mutated lung adenocarcinoma diagnosed from endometrial polyp metastasis: a case report and literature review. Turkish Journal of Obstetrics and Gynecology. 2022; 19: 81–86.

[5] Morrison J, Balega J, Buckley L, Clamp A, Crosbie E, Drew Y, et al. British Gynaecological Cancer Society (BGCS) uterine cancer guidelines: recommendations for practice. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2022; 270: 50–89.

[6] Concin N, Planchamp F, Abu-Rustum NR, Ataseven B, Cibula D, Fagotti A, et al. European Society of Gynaecological Oncology quality indicators for the surgical treatment of endometrial carcinoma. International Journal of Gynecological Cancer. 2021; 31: 1508–1529.

[7] Frey MK, Blank SV, Curtin JP. Minimizing minimally invasive surgery for endometrial carcinoma. American Society of Clinical Oncology Educational Book. 2017; 37: 23–28.

[8] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Systematic Reviews. 2021; 10: 89.

[9] World Health Organization. Indicator metadata registry list-income level. Available at: https://www.who.int/data/gho/indicator-metadata-registry/imr-details/193 (Accessed: 18 January 2025).

[10] Rettenmaier MA, Mendivil AA, Brown JV III, Abaid LN, Micha JP, Goldstein BH. Same-day discharge in clinical stage I endometrial cancer patients treated with total laparoscopic hysterectomy, bilateral salpingo-oophorectomy and bilateral pelvic lymphadenectomy. Oncology. 2012; 82: 321–326.

[11] Lee J, Aphinyanaphongs Y, Curtin JP, Chern JY, Frey MK, Boyd LR. The safety of same-day discharge after laparoscopic hysterectomy for endometrial cancer. Gynecologic Oncology. 2016; 142: 508–513.

[12] Praiss AM, Chen L, St Clair CM, Tergas AI, Khoury-Collado F, Hou JY, et al. Safety of same-day discharge for minimally invasive hysterectomy for endometrial cancer. American Journal of Obstetrics & Gynecology. 2019; 221: 239.e1–239.e11.

[13] Cappuccio S, Li Y, Song C, Liu E, Glaser G, Casarin J, et al. The shift from inpatient to outpatient hysterectomy for endometrial cancer in the United States: trends, enabling factors, cost, and safety. International Journal of Gynecological Cancer. 2021; 31: 686–693.

[14] Tait DL, Lehman A, Brown J, Crane EK, Kemp EV, Taylor VD, et al. Comparison of perioperative outcomes between minimally invasive sentinel node biopsy and full lymphadenectomy for endometrial cancer. Journal of Minimally Invasive Gynecology. 2021; 28: 1514–1518.

[15] Dioun S, Chen L, Melamed A, Gockley A, St Clair CM, Hou JY, et al. Uptake and outcomes of sentinel lymph node mapping in women undergoing minimally invasive surgery for endometrial cancer. BJOG: An International Journal of Obstetrics and Gynaecology. 2022; 129: 1591–1599.

[16] Lees BF, Johnson S, Donahue E, Bose R, Brown J, Crane E, et al. Improved rates of same-day discharge in patients undergoing surgery for endometrial cancer following the COVID-19 pandemic. Journal of Minimally Invasive Gynecology. 2022; 29: 1248–1252.

[17] Mateshaytis J, Brawner M, Steed H, Pin S. Improving the rate of same-day discharge in gynecologic oncology patients with endometrial cancer undergoing minimally invasive robotic surgery: a quality improvement initiative. Journal of Minimally Invasive Gynecology. 2022; 29: 1184–1193.

[18] Son J, Tran T, Yao M, Michener CM. Factors associated with unplanned admission in patients intended for same day discharge after minimally invasive hysterectomy for endometrial cancer. Surgical Innovation. 2022; 29: 336–342.

[19] Zhang N, Wilson B, Enty MA, Ketch P, Ulm MA, ElNaggar AC, et al. Same-day discharge after robotic surgery for endometrial cancer. Journal of Robotic Surgery. 2022; 16: 543–548.

[20] Giannini A, Magrina JF, Magtibay PM, Butler KA. Same-day dismissal for endometrial cancer robotic surgery: feasibility factors. Updates in Surgery. 2023; 75: 743–755.

[21] Melamed A, Katz Eriksen JL, Hinchcliff EM, Worley MJ III, Berkowitz RS, Horowitz NS, et al. Same-day discharge after laparoscopic hysterectomy for endometrial cancer. Annals of Surgical Oncology. 2016; 23: 178–185.

[22] Mathis MR, Naughton NN, Shanks AM, Freundlich RE, Pannucci CJ, Chu Y, et al. Patient selection for day case-eligible surgery: identifying those at high risk for major complications. Anesthesiology. 2013; 119: 1310–1321.

[23] Liu J, Chen Y, Tan X, Chen H. Factors influencing same-day discharge after minimally invasive hysterectomy for malignant and non-malignant gynecological diseases: a systematic review and meta-analysis. Frontiers in Oncology. 2023; 13: 1307694.

[24] Lee SJ, Calderon B, Gardner GJ, Mays A, Nolan S, Sonoda Y, et al. The feasibility and safety of same-day discharge after robotic-assisted hysterectomy alone or with other procedures for benign and malignant indications. Gynecologic Oncology. 2014; 133: 552–555.

[25] Tsibulak I, Collins A, Hsu HC, Chacon E, Bizzarri N, Baleka AM, et al. Global survey on training and practice in sentinel lymph node mapping for endometrial and cervical cancer among early-career gynecologic oncologists. International Journal of Gynecological Cancer. 2025; 35: 100050.