PT  - JOURNAL ARTICLE
AU  - C Fitszimmons
AU  - A Stephens
AU  - J Kennard
AU  - M Manyam
AU  - J Pepe
AU  - K DeCoff
AU  - S Ahmad
AU  - N McKenzie
AU  - J Kendrick
AU  - R Holloway
TI  - 168 Recurrence and survival after robotic-assisted radical hysterectomy (RRH) for early stage cervical cancer (CC): experience may matter
AID  - 10.1136/ijgc-2019-IGCS.168
DP  - 2019 Sep 01
TA  - International Journal of Gynecologic Cancer
PG  - A76--A76
VI  - 29
IP  - Suppl 3
4099  - http://ijgc.bmj.com/content/29/Suppl_3/A76.1.short
4100  - http://ijgc.bmj.com/content/29/Suppl_3/A76.1.full
SO  - Int J Gynecol Cancer2019 Sep 01; 29
AB  - Objectives In light of the LACC Trial results, we evaluated RFS and OS following RRH before and after 10 cases per surgeon.Methods Patients with early-stage CC (4/2007–12/2017) who underwent RRH were evaluated and first 10 learning curve cases per surgeon (Group A) were compared to all subsequent cases (Group B). Inclusion criteria mirrored the LACC trial: > one-year follow-up, adenocarcinoma or squamous carcinoma, FIGO-2014 stage IA2 or IB1, and pathologic tumor size of ≤4 cm.Results 144 RRH patients were identified and 90 met inclusion criteria from 6 attending surgeons. 40 patients met Group A and 50 Group B criteria. Median follow-up was 61± 34.3 months (A=71.5, B=52.5). The 5-year RFS was 92% (95 CI±4%) and the DSDR 5.5% (n=5). There were 7(7.8%) recurrences with median RFS of 12±8.3 months. Recurrence in Group A (n=6, 15%) exceeded Group B (n=1, 2%), p=0.025. DSDR was 10% Group A vs. 2% B (p=0.184). The 4.5-year RFS was 84.8% (95 CI±7%) in Group A vs. 98% (95 CI±3%) in Group B. There were no differences in risk factors for recurrence between groups A and B. (TS >2, LN (+), adjuvant therapy (AT), and LVSI p>0.05), except (+) vaginal margin status (A=10% vs B=0%, p=0.034). All recurrent cases had TS >2 cm.Conclusions Recurrence of disease following RRH clustered in the first 10 cases per surgeon in our center and was associated with (+) vaginal margins and TS 2 cm. This data suggests an inter-surgeon variability and a possible learning curve effect.