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RESEARCH PRODUCT
Robotic versus laparoscopic radical hysterectomy in early cervical cancer: A case matched control study
Alex FedericoFrancesco CosentinoSilvia PelligraValerio GallottaGiovanni ScambiaAnna FagottiLucia TortorellaVito ChianteraGabriella FerrandinaGiuseppe VizzielliLuigi Pedone AnchoraSalvatore Gueli AllettiCarmine ConteMarco D'indinosantesubject
Uterine Cervical NeoplasmTime Factorsmedicine.medical_treatmentEarly stage cervical cancerUterine Cervical Neoplasms0302 clinical medicinePostoperative ComplicationsRetrospective StudieLaparotomy80 and overMedicineEarly Detection of CancerEarly stage cervical cancer; Laparoscopy; Robotic surgery; Adult; Aged; Aged 80 and over; Female; Humans; Hysterectomy; Incidence; Italy; Laparoscopy; Middle Aged; Postoperative Complications; Retrospective Studies; Robotics; Survival Rate; Time Factors; Uterine Cervical Neoplasms; Young Adult; Early Detection of Cancer; Neoplasm Staging; Surgery; OncologyAged 80 and over030219 obstetrics & reproductive medicineIncidenceGeneral MedicineRoboticsMiddle AgedSurvival RateOncologyItaly030220 oncology & carcinogenesisFemaleHumanAdultmedicine.medical_specialtyTime FactorHysterectomy03 medical and health sciencesYoung AdultHumansRobotic surgeryRadical surgeryRadical HysterectomySurvival rateRetrospective StudiesAgedNeoplasm StagingHysterectomybusiness.industryRobotic surgeryPerioperativeSurgeryRoboticSettore MED/40 - GINECOLOGIA E OSTETRICIASurgeryLymphadenectomyLaparoscopyPostoperative Complicationbusinessdescription
Abstract Background This study aims at evaluating the feasibility, surgical outcome and oncological results observed after robotic radical hysterectomy (RH) compared to laparoscopy for patients with early stage cervical cancer (ECC) patients. Methods Between January 2010 and October 2016, 210 patients underwent RH for treatment of ECC: 70 underwent robotic approach (Cases), and 140 underwent laparoscopic approach (Controls). Results There was no statistically significant difference between the two approaches with regard to clinical patient characteristics and in terms of extent of RH and rate of pelvic and aortic lymphadenectomy. Operative time was significantly longer in the robotic versus laparoscopic group (median = 243 min, range 90–612 versus median = 210 min, range 80–660; p value = 0.008). Conversion to laparotomy was necessary in 4 patients (1.9%) in the whole series. No difference was found in terms of intraoperative and postoperative complications between the two groups. Overall, during the observation period, 34 (16.2%) patients experienced any grade postoperative complications, and 21 (10.0%) had >G2 complications. The 3-yr DFS was 88.0% versus 84.0% in robotic and laparoscopic group, respectively (p value = 0.866). Central and/or lateral pelvic disease represented the most common site of relapse. The 3-yr OS was 90.8% in patients underwent robotic RH versus 94.0% in patients underwent laparoscopic RH (p value = 0.924). Conclusions The present study shows the equivalence of robotic and laparoscopic approaches to radical surgery of ECC patients, in terms of perioperative and postoperative outcomes with equivalent survival figures, and thus the choice of approach can be tailored to the choice of patient and surgeon.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-01-01 |