Robotic versus laparoscopic radical hysterectomy in early cervical cancer: A case matched control study

Valerio Gallotta, Carmine Conte, Alex Federico, Giuseppe Vizzielli, Salvatore Gueli Alletti, Lucia Tortorella, Luigi Pedone Anchora, Francesco Cosentino, Vito Chiantera, Anna Fagotti, Marco D'Indinosante, Silvia Pelligra, Giovanni Scambia, Gabriella Ferrandina

Research output: Contribution to journalArticle

Abstract

Background: This study aims at evaluating the feasibility, surgical outcome and oncological results observed after robotic radical hysterectomy (RH) compared to laparoscopy for patients with early stage cervical cancer (ECC) patients. Methods: Between January 2010 and October 2016, 210 patients underwent RH for treatment of ECC: 70 underwent robotic approach (Cases), and 140 underwent laparoscopic approach (Controls). Results: There was no statistically significant difference between the two approaches with regard to clinical patient characteristics and in terms of extent of RH and rate of pelvic and aortic lymphadenectomy. Operative time was significantly longer in the robotic versus laparoscopic group (median = 243 min, range 90–612 versus median = 210 min, range 80–660; p value = 0.008). Conversion to laparotomy was necessary in 4 patients (1.9%) in the whole series. No difference was found in terms of intraoperative and postoperative complications between the two groups. Overall, during the observation period, 34 (16.2%) patients experienced any grade postoperative complications, and 21 (10.0%) had >G2 complications. The 3-yr DFS was 88.0% versus 84.0% in robotic and laparoscopic group, respectively (p value = 0.866). Central and/or lateral pelvic disease represented the most common site of relapse. The 3-yr OS was 90.8% in patients underwent robotic RH versus 94.0% in patients underwent laparoscopic RH (p value = 0.924). Conclusions: The present study shows the equivalence of robotic and laparoscopic approaches to radical surgery of ECC patients, in terms of perioperative and postoperative outcomes with equivalent survival figures, and thus the choice of approach can be tailored to the choice of patient and surgeon.

Original languageEnglish
Pages (from-to)754-759
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume44
Issue number6
DOIs
Publication statusPublished - Jun 1 2018

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Robotics
Hysterectomy
Uterine Cervical Neoplasms
Case-Control Studies
Intraoperative Complications
Operative Time
Lymph Node Excision
Laparoscopy
Laparotomy
Observation
Recurrence
Survival

Keywords

  • Early stage cervical cancer
  • Laparoscopy
  • Robotic surgery

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Robotic versus laparoscopic radical hysterectomy in early cervical cancer : A case matched control study. / Gallotta, Valerio; Conte, Carmine; Federico, Alex; Vizzielli, Giuseppe; Gueli Alletti, Salvatore; Tortorella, Lucia; Pedone Anchora, Luigi; Cosentino, Francesco; Chiantera, Vito; Fagotti, Anna; D'Indinosante, Marco; Pelligra, Silvia; Scambia, Giovanni; Ferrandina, Gabriella.

In: European Journal of Surgical Oncology, Vol. 44, No. 6, 01.06.2018, p. 754-759.

Research output: Contribution to journalArticle

Gallotta, V, Conte, C, Federico, A, Vizzielli, G, Gueli Alletti, S, Tortorella, L, Pedone Anchora, L, Cosentino, F, Chiantera, V, Fagotti, A, D'Indinosante, M, Pelligra, S, Scambia, G & Ferrandina, G 2018, 'Robotic versus laparoscopic radical hysterectomy in early cervical cancer: A case matched control study', European Journal of Surgical Oncology, vol. 44, no. 6, pp. 754-759. https://doi.org/10.1016/j.ejso.2018.01.092
Gallotta, Valerio ; Conte, Carmine ; Federico, Alex ; Vizzielli, Giuseppe ; Gueli Alletti, Salvatore ; Tortorella, Lucia ; Pedone Anchora, Luigi ; Cosentino, Francesco ; Chiantera, Vito ; Fagotti, Anna ; D'Indinosante, Marco ; Pelligra, Silvia ; Scambia, Giovanni ; Ferrandina, Gabriella. / Robotic versus laparoscopic radical hysterectomy in early cervical cancer : A case matched control study. In: European Journal of Surgical Oncology. 2018 ; Vol. 44, No. 6. pp. 754-759.
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abstract = "Background: This study aims at evaluating the feasibility, surgical outcome and oncological results observed after robotic radical hysterectomy (RH) compared to laparoscopy for patients with early stage cervical cancer (ECC) patients. Methods: Between January 2010 and October 2016, 210 patients underwent RH for treatment of ECC: 70 underwent robotic approach (Cases), and 140 underwent laparoscopic approach (Controls). Results: There was no statistically significant difference between the two approaches with regard to clinical patient characteristics and in terms of extent of RH and rate of pelvic and aortic lymphadenectomy. Operative time was significantly longer in the robotic versus laparoscopic group (median = 243 min, range 90–612 versus median = 210 min, range 80–660; p value = 0.008). Conversion to laparotomy was necessary in 4 patients (1.9{\%}) in the whole series. No difference was found in terms of intraoperative and postoperative complications between the two groups. Overall, during the observation period, 34 (16.2{\%}) patients experienced any grade postoperative complications, and 21 (10.0{\%}) had >G2 complications. The 3-yr DFS was 88.0{\%} versus 84.0{\%} in robotic and laparoscopic group, respectively (p value = 0.866). Central and/or lateral pelvic disease represented the most common site of relapse. The 3-yr OS was 90.8{\%} in patients underwent robotic RH versus 94.0{\%} in patients underwent laparoscopic RH (p value = 0.924). Conclusions: The present study shows the equivalence of robotic and laparoscopic approaches to radical surgery of ECC patients, in terms of perioperative and postoperative outcomes with equivalent survival figures, and thus the choice of approach can be tailored to the choice of patient and surgeon.",
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T2 - A case matched control study

AU - Gallotta, Valerio

AU - Conte, Carmine

AU - Federico, Alex

AU - Vizzielli, Giuseppe

AU - Gueli Alletti, Salvatore

AU - Tortorella, Lucia

AU - Pedone Anchora, Luigi

AU - Cosentino, Francesco

AU - Chiantera, Vito

AU - Fagotti, Anna

AU - D'Indinosante, Marco

AU - Pelligra, Silvia

AU - Scambia, Giovanni

AU - Ferrandina, Gabriella

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N2 - Background: This study aims at evaluating the feasibility, surgical outcome and oncological results observed after robotic radical hysterectomy (RH) compared to laparoscopy for patients with early stage cervical cancer (ECC) patients. Methods: Between January 2010 and October 2016, 210 patients underwent RH for treatment of ECC: 70 underwent robotic approach (Cases), and 140 underwent laparoscopic approach (Controls). Results: There was no statistically significant difference between the two approaches with regard to clinical patient characteristics and in terms of extent of RH and rate of pelvic and aortic lymphadenectomy. Operative time was significantly longer in the robotic versus laparoscopic group (median = 243 min, range 90–612 versus median = 210 min, range 80–660; p value = 0.008). Conversion to laparotomy was necessary in 4 patients (1.9%) in the whole series. No difference was found in terms of intraoperative and postoperative complications between the two groups. Overall, during the observation period, 34 (16.2%) patients experienced any grade postoperative complications, and 21 (10.0%) had >G2 complications. The 3-yr DFS was 88.0% versus 84.0% in robotic and laparoscopic group, respectively (p value = 0.866). Central and/or lateral pelvic disease represented the most common site of relapse. The 3-yr OS was 90.8% in patients underwent robotic RH versus 94.0% in patients underwent laparoscopic RH (p value = 0.924). Conclusions: The present study shows the equivalence of robotic and laparoscopic approaches to radical surgery of ECC patients, in terms of perioperative and postoperative outcomes with equivalent survival figures, and thus the choice of approach can be tailored to the choice of patient and surgeon.

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