Oncological outcome and long‐term complications in robot‐assisted radical surgery for early stage cervical cancer: an observational cohort study. (16th April 2014) - Hoogendam, JP
Abstract Objective To report the oncological outcome and long‐term complications of radical surgery by robot‐assisted laparoscopy in early stage cervical cancer. Design Observational cohort study. Setting Tertiary referral centre. Population About 100 cervical cancer patients treated consecutively with robot‐assisted radical surgery between 2008 and 2013. Methods Two gynaecological oncologists specialised in minimally invasive surgery performed all surgeries on a three/four‐armed robotic system. Procedures consisted of pelvic lymph node dissection combined with a radical hysterectomy, radical vaginal trachelectomy or parametrectomy. Main outcome measures Recurrence, survival and long‐term complication rates. Results 104 robot‐assisted laparoscopies were performed in 100 patients (stage IA1–IIB), with a median follow‐up of 29.5 months (range 2.5–67.1 months). Thirteen cases were diagnosed with a loco‐regional (8%), distant (4%) or combined (1%) recurrence at a median of 14.4 months (range 2.9–34.8 months). All mortality (7%) was cervical cancer‐related and due to recurrent disease. Four recurrences receive palliative care and two are in complete remission. The overall 5‐year progression‐free and disease‐specific survival rates are 81.4 and 88.7%, respectively. Frequent complications were lymphoedema (26%), lower urinary tract symptoms (19%), urinary tract infection (17%) and sexual disorders (9%). Five patients had a vaginal cuff dehiscence. No complication‐related mortality occurred. Conclusion The recurrence, survival and long‐term complication rates of robot‐assisted radical surgery for early stage cervical cancer in this cohort are reassuring concerning its continued clinical use.