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Surgical and Oncological Outcome of Robotic Surgery Compared With Laparoscopic and Abdominal Surgery in the Management of Locally Advanced Cervical Cancer After Neoadjuvant Chemotherapy
  1. Giacomo Corrado, MD, PhD*,
  2. Giuseppe Cutillo, MD*,
  3. Maria Saltari, MD,
  4. Emanuela Mancini, MD*,
  5. Stefano Sindico, MD,
  6. Patrizia Vici, MD,
  7. Domenico Sergi, MD,
  8. Isabella Sperduti, MD§,
  9. Lodovico Patrizi, MD,
  10. Giulia Pomati, MD,
  11. Ermelinda Baiocco, MD* and
  12. Enrico Vizza, MD, PhD*
  1. *Gynecologic Oncology Unit,“Regina Elena” National Cancer Institute;
  2. Department of Surgery, Section of Gynaecology and Obstetrics, Tor Vergata University of Rome; and
  3. Division of Medical Oncology B and
  4. §Scientific Direction,“Regina Elena” National Cancer Institute, Rome, Italy.
  1. Address correspondence and reprint requests to Giacomo Corrado, MD, PhD, Department of Oncological Surgery, Gynecologic Oncology Unit, “Regina Elena” National Cancer Institute, IFO, Via Elio Chianesi 53 00144, Rome, Italy. E-mail: giacomo.corrado@alice.it.

Abstract

Objective The primary aim is to evaluate the surgical and oncological outcome of robotic radical hysterectomy (RRH) plus pelvic lymphadenectomy in locally advanced cervical cancer (LACC) after neoadjuvant chemotherapy (NACT). The secondary aim is to compare the surgical and oncological results of RRH after NACT with a historical cohort of patients undergoing laparoscopic radical hysterectomy or abdominal radical hysterectomy plus pelvic lymphadenectomy for LACC after NACT.

Methods We enrolled a total of 41 patients in this study with LACC undergoing RRH, who achieved a clinical partial or complete response to NACT. The surgical and oncological outcomes of 2 historical groups were compared: the laparoscopic group (41 patients) with the laparotomic group (43 patients).

Results The median estimated blood loss, operative time, and length of hospital stay were statistically significant and in favor of the robotic group. No conversion to laparotomy in the robotic group was necessary. There were no significant differences between the 3-year overall survival and disease-free survival rates in the minimally invasive groups; nevertheless, the robotic group showed the same recurrence rate of laparoscopic in a short-interval follow-up.

Conclusions The robotic approach could be considered a feasible and safe alternative to other surgical options. Multicenter randomized clinical trials with longer follow-ups are necessary to evaluate the overall oncologic outcomes of this procedure.

  • Locally advanced cervical cancer
  • Minimally invasive surgery
  • Neoadjuvant chemotherapy
  • Robot-assisted radical hysterectomy

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Footnotes

  • This work was not supported by any source of funding.

  • The authors declare no conflicts of interest.

  • The authors are responsible for the content and writing of the article.

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