Oncologic Outcomes of Robotic Radical Hysterectomy (RRH) for Patients with Early-Stage Cervical Cancer: Experience at a Referral Cancer Center

Purpose To evaluate oncologic outcomes of early stage cervical cancer patients who underwent robotic radical hysterectomy (RRH) in a referral center, a retrospective analysis was performed. Methods From January 2010 to December 2018, medical records of stage IA2-IIA1 cervical cancer patients, who underwent radical hysterectomy at our institute, were retrospectively reviewed. We focused our analysis on those who underwent RRH. Results A total of 198 patients were included in the final analysis. Median follow up was 52 months. At last follow-up, 188 (94.9%) women were disease-free, 9 (4.5%) had died, and 1 (0.5%) was alive with recurrent disease. At 4.5 years, PFS was 93.1% (SE +/- 2.1) and OS was 95.1% (SE +/- 1.8). Stratified by tumor size, PFS for tumor < 2 cm versus tumor >= 2 cm was statistically different (96.8% +/- 2.3 and 87.9% +/- 4.1 respectively,p = 0.01), as well as OS (100% and 89.8% +/- 40 respectively,p = 0.01).Stratified by evidence of tumor at time of robotic surgery, PFS was statistically different in women with no residual tumor after conisation versus those with residual disease (100% +/- 2.5 and 90.8% +/- 2.8 respectively,p = 0.04). A recurrence occurred in 11 patients (5.6%). Conclusions Based on our results, we could speculate that robotic approach, along with some technical precautions to avoid spillage, might be safe as primary treatment of early-stage cervical cancer, especially for tumor < 2 cm and in case of no evidence of disease at time of radical hysterectomy after previous conisation.

Automated summary

The study evaluated the oncologic outcomes of early stage cervical cancer patients who underwent robotic radical hysterectomy in a referral center. Results showed that the robotic approach could be safe as a primary treatment for early-stage cervical cancer, especially for tumors smaller than 2 cm and in cases with no evidence of disease at the time of surgery.