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Clinical and Oncologic Outcomes of Robotic Versus Abdominal Radical Hysterectomy for Women With Cervical Cancer: Experience at a Referral Cancer Center
- Source :
- International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 26(3)
- Publication Year :
- 2016
-
Abstract
- Objectives To compare the clinical and oncologic outcomes of robotic radical hysterectomy (RRH) vs abdominal radical hysterectomy (ARH) in patients with cervical carcinoma. Methods A retrospective analysis of women who underwent radical hysterectomy for cervical cancer from December 2006 to December 2014 at European Institute of Oncology was performed. Patients who underwent RRH were compared with women operated on by ARH. The groups were matched by age, body mass index, tumor size, International Federation of Gynecology and Obstetrics stage, comorbidity, previous neoadjuvant chemotherapy, histology type, and tumor grade. Results A total of 203 and 104 women who underwent RRH and ARH, respectively, were analyzed. Baseline characteristics, stage of disease, histology type, and grade of differentiation were similar between groups. Surgical time was significantly shorter in the ARH group (208 vs 282 minutes, P ⩽ 0.001). Robotic radical hysterectomy was associated with significantly less estimated blood loss (219 vs 104 mL, P = 0.001) and with significantly shorter hospital stay (5.2 vs 3.9 days, P ⩽ 0.001). Abdominal radical hysterectomy was correlated with a significantly higher number of lymph nodes removed (25.8 vs 22, P = 0.003). None of the robotic procedures required conversion to laparotomy. A significantly higher number of patients in ARH required postoperative transfusion (11 [10.5%] vs 6 [2.9%], P = 0.006). Lower extremity lymphedema was significantly higher in ARH (28 [27.5%] vs 17 [8.3%], P = 0.001). Recurrence rates as well as progression-free survival and overall survival were similar between groups at a median follow-up of 41.64 months. Conclusions Robotic radical hysterectomy is safe and feasible and is associated with improved clinical outcomes. Although longer follow-up is needed, early data show equivalent oncologic outcomes compared with other surgical modalities.
- Subjects :
- Uterine Cervical Neoplasm
medicine.medical_treatment
Uterine Cervical Neoplasms
0302 clinical medicine
Postoperative Complications
Robotic Surgical Procedures
Retrospective Studie
Laparotomy
Abdomen
Overall survival
Abdominal radical hysterectomy
Referral and Consultation
Neoadjuvant therapy
Cervical cancer
030219 obstetrics & reproductive medicine
Obstetrics and Gynecology
Progression-free survival
Middle Aged
Prognosis
Neoadjuvant Therapy
Survival Rate
Oncology
030220 oncology & carcinogenesis
Carcinoma, Squamous Cell
Female
Human
Adult
medicine.medical_specialty
Robotic Surgical Procedure
Prognosi
Adenocarcinoma
Hysterectomy
Follow-Up Studie
03 medical and health sciences
Robotic radical hysterectomy
medicine
Humans
Neoplasm Invasiveness
Radical Hysterectomy
Survival rate
Neoplasm Staging
Retrospective Studies
Neoplasm Invasivene
business.industry
Retrospective cohort study
medicine.disease
Surgery
Postoperative Complication
Neoplasm Recurrence, Local
business
Complication
Follow-Up Studies
Subjects
Details
- ISSN :
- 15251438
- Volume :
- 26
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
- Accession number :
- edsair.doi.dedup.....9de94dba3c1f899207b4f82afe587ef6