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601 Increased institutional surgical experience in robot-assisted radical hysterectomy for early stage cervical cancer reduces recurrence rate. results from a nationwide study
  1. Linnea Ekdahl1,
  2. Emelie Wallin2,
  3. Emilia Alfonzo3,
  4. Petur Reynisson1,
  5. Celine Lönnerfors1,
  6. Pernilla Dahm-Kähler3,
  7. Henrik Falconer2 and
  8. Jan Persson1
  1. 1Skåne University Hospital and Lund University Faculty of Medicine
  2. 2Karolinska Institutet
  3. 3Sahlgrenska Academy at University of Gothenburg


Introduction/Background The aim of this study was to evaluate the impact of institutional surgical experience on recurrence following robotic radical hysterectomy (RRH) for early stage cervical cancer.

Methodology All women in Sweden who underwent an RRH for stage IA2-IB1 cervical cancer at tertiary referral centers from its implementation in December 2005 until June 2017 were identified using a Swedish nationwide register and local hospital registers. Registry data was controlled by a chart review on all women. Recurrence rates and pattern of recurrence was compared between early and late (≤50 vs >50 procedures) institutional series.

Results 635 women were included. Regression analysis identified a lower risk of recurrence with increased experience but without a clear cut off level. Among the 489 women who did not receive adjuvant radio chemotherapy (RC-T), the rate of recurrence was 3.6% in the experienced cohort (>50 procedures) compared to 9.3% in the introductory cohort (p<0.05). This was also seen in tumors <2 cm regardless of RC-T (p<0.05) whereas no difference in recurrence was seen when analyzing all women receiving RC-T.

Conclusion In conclusion, the rate of recurrence following RRH for early stage cervical cancer decreased with increased institutional surgical experience, in tumors <2 cm and in women who did not receive adjuvant RC-T.

Disclosures Jan Persson, Henrik Falconer and Celine Lönnerfors have received honoraria for lectures and proctoring in robotic surgery, all outside the presented research. The other authors have no conflicts of interest.

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