Oncological outcome and long-term complications in robot-assisted radical surgery for early stage cervical cancer: an observational cohort study

Authors

  • JP Hoogendam,

    Corresponding author
    1. Department of Gynaecological Oncology, Woman and Baby Division, University Medical Centre Utrecht, Utrecht, the Netherlands
    • Correspondence: Dr JP Hoogendam, Department of Gynaecological Oncology, Woman and Baby Division, University Medical Centre Utrecht, Utrecht, F05.126, PO Box 3508, 3508 GA, the Netherlands. Email j.hoogendam@umcutrecht.nl

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  • RHM Verheijen,

    1. Department of Gynaecological Oncology, Woman and Baby Division, University Medical Centre Utrecht, Utrecht, the Netherlands
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  • I Wegner,

    1. Department of Gynaecological Oncology, Woman and Baby Division, University Medical Centre Utrecht, Utrecht, the Netherlands
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  • RP Zweemer

    1. Department of Gynaecological Oncology, Woman and Baby Division, University Medical Centre Utrecht, Utrecht, the Netherlands
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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.

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