Robot-assisted versus open radical hysterectomy: A multi-institutional experience for early-stage cervical cancer.

Autor: Sert BM; Department of Gynecological Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway. Electronic address: sbi@ous-hf.no., Boggess JF; Department of Gynecologic Oncology, University of North Carolina, Chapel Hill, NC, USA., Ahmad S; Department of Gynecologic Oncology, Florida Hospital Cancer Institute, Orlando, FL, USA., Jackson AL; Department of Gynecologic Oncology, University of North Carolina, Chapel Hill, NC, USA; Division of Gynecological Oncology, University of Cincinnati Medical Center, Cincinnati, OH, USA., Stavitzski NM; Department of Gynecologic Oncology, Florida Hospital Cancer Institute, Orlando, FL, USA., Dahl AA; National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway., Holloway RW; Department of Gynecologic Oncology, Florida Hospital Cancer Institute, Orlando, FL, USA.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2016 Apr; Vol. 42 (4), pp. 513-22. Date of Electronic Publication: 2016 Jan 21.
DOI: 10.1016/j.ejso.2015.12.014
Abstrakt: Objective: To compare perioperative and clinico-pathological outcomes of patients with early-stage cervical cancer who underwent robot-assisted radical hysterectomy (RRH) and open radical hysterectomy (ORH).
Methods: This retrospective multi-center study abstracted demographic, clinico-pathological and perioperative outcomes data from medical records of 491 cervical cancer patients treated with RRH (n = 259) ORH (n = 232) between 2005 and 2011 at two American and one Norwegian University Cancer Centres.
Results: Mean estimated blood loss (EBL) and transfusion rates were less for RRH than for ORH (97 vs. 49 mL, p < 0.001, and 3% vs. 7%, p = 0.018, respectively). Mean length of hospital stay (LOS) was significantly shorter in RRH versus ORH (1.8 vs. 5.1 days, p < 0.001). Mean operative time was longer for RRH than ORH (220 vs. 156 min, p < 0.001). Although overall complications were similar (p = 0.49), intra-operative complications were less common in the RRH group than ORH (4% vs. 10%, p = 0.004). In multivariate regression analyses longer operative time, less EBL and intra-operative complications, shorter LOS, and more pre-operative cone were significantly associated with RRH versus ORH. Recurrence and death rates were not statistically different for the two groups at a mean follow-up time of 39 months (p = 1.00 and p = 0.48, respectively).
Conclusions: RRH had improved clinical outcomes compared to ORH in the treatment of early-stage cervical cancer in terms of EBL, intra-operative complications, transfusion rates, LOS, and pre-operative cone. Disease recurrence and survival were comparable for the two procedures.
(Copyright © 2016 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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