Surgical outcomes of robotic radical hysterectomy after neoadjuvant chemotherapy for locally advanced cervical cancer: comparison with early stage disease

Eur J Surg Oncol. 2013 Jan;39(1):87-93. doi: 10.1016/j.ejso.2012.10.001. Epub 2012 Oct 31.

Abstract

Aims: To evaluate the feasibility and safety of robotic radical hysterectomy (RRH) with pelvic lymphadenectomy for locally advanced cervical cancer (LACC) after neoadjuvant chemotherapy (NACT).

Methods: Starting from 04/2009, consecutive patients with LACC were submitted to robotic surgical staging after NACT. Surgical outcomes were compared to those achieved by women undergoing robotic surgery for an early stage disease during the same temporal interval.

Results: Overall 25 (Group 1) and 21 (Group 2) patients had an early stage and a LACC, respectively. Among women with LACC, 18 achieved best tumor responses to NACT and therefore they were addressed to RRH. Outcomes resulted comparable between Groups in terms of operative time, blood loss, hospitalization and complications. No differences were found in terms of nodal yield, parametrial and vaginal cuff length.

Conclusions: RRH is feasible and safe also in patients previously submitted to NACT for LACC. Larger series with longer follow-up are mandatory to establish survival outcomes.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / pathology
  • Adenocarcinoma / radiotherapy
  • Adenocarcinoma / surgery
  • Adenocarcinoma / therapy*
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Brachytherapy
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Carcinoma, Squamous Cell / therapy*
  • Cisplatin / administration & dosage
  • Dose Fractionation, Radiation
  • Epirubicin / administration & dosage
  • Feasibility Studies
  • Female
  • Humans
  • Hysterectomy / adverse effects
  • Hysterectomy / instrumentation*
  • Hysterectomy / methods
  • Ifosfamide / administration & dosage
  • Laparoscopy
  • Lymph Node Excision
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Paclitaxel / administration & dosage
  • Prospective Studies
  • Radiotherapy, Adjuvant
  • Robotics*
  • Safety
  • Treatment Outcome
  • Uterine Cervical Neoplasms / drug therapy
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / radiotherapy
  • Uterine Cervical Neoplasms / surgery
  • Uterine Cervical Neoplasms / therapy*
  • Vagina

Substances

  • Epirubicin
  • Paclitaxel
  • Cisplatin
  • Ifosfamide