Survival after a nationwide adoption of robotic minimally invasive surgery for early-stage cervical cancer – A population-based study

Autor: Katrine Fuglsang, Algirdas Markauskas, Kirsten Marie Jochumsen, Tine H. Schnack, Jacob Dinesen, Erik Søgaard-Andersen, Henrik Lajer, Laura H. Øster, Signe Frahm Bjørn, Charlotte Hasselholt Søgaard, Ligita Paskeviciute Frøding, Aage Knudsen, Marianne Jensen, Claus Høgdall, Pernille Tine Jensen
Rok vydání: 2020
Předmět:
Adult
Cancer-specific survival
0301 basic medicine
Cancer Research
medicine.medical_specialty
Disease-free survival
Denmark
Population
Uterine Cervical Neoplasms
Hysterectomy
Risk Assessment
Disease-Free Survival
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Robotic Surgical Procedures
Minimally invasive surgery
Internal medicine
medicine
Humans
Radical hysterectomy
Overall survival
Robotic surgery
education
Cancer recurrence
Neoplasm Staging
Proportional Hazards Models
Population-based study
Cause of death
Cervical cancer
education.field_of_study
business.industry
Proportional hazards model
Uterus
Hazard ratio
Middle Aged
medicine.disease
Survival Rate
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Cohort
Female
Neoplasm Recurrence
Local
business
Follow-Up Studies
Cohort study
Zdroj: Jensen, P T, Schnack, T H, Frøding, L P, Bjørn, S F, Lajer, H, Markauskas, A, Jochumsen, K M, Fuglsang, K, Dinesen, J, Søgaard, C H, Søgaard-Andersen, E, Jensen, M M, Knudsen, A, Øster, L H & Høgdall, C 2020, ' Survival after a nationwide adoption of robotic minimally invasive surgery for early-stage cervical cancer-A population-based study ', European Journal of Cancer, vol. 128, pp. 47-56 . https://doi.org/10.1016/j.ejca.2019.12.020
Jensen, P T, Schnack, T H, Frøding, L P, Bjørn, S F, Lajer, H, Markauskas, A, Jochumsen, K M, Fuglsang, K, Dinesen, J, Søgaard, C H, Søgaard-Andersen, E, Jensen, M M, Knudsen, A, Øster, L H & Høgdall, C 2020, ' Survival after a nationwide adoption of robotic minimally invasive surgery for early-stage cervical cancer – A population-based study ', European Journal of Cancer, vol. 128, pp. 47-56 . https://doi.org/10.1016/j.ejca.2019.12.020
ISSN: 0959-8049
Popis: AIM: Lately, the safety of minimally invasive surgery (MIS) in the treatment of cervical cancer (CC) has been questioned. This study aimed to evaluate the risk of recurrence and survival after a nationwide adoption of robotic MIS for the treatment of early-stage CC in Denmark.METHODS: Population-based data on all Danish women with early-stage CC, who underwent radical hysterectomy January 1st 2005-June 30th 2017 were retrieved from the Danish Gynecologic Cancer Database and enriched with follow-up data on recurrence, death and cause of death. The cohort was divided into two groups according to the year of robotic MIS introduction at each cancer centre. Chi-squared or Fischer test, the Kaplan Meier method and multivariate Cox regression were used for comparison between groups.RESULTS: One thousand one hundred twenty-five patients with CC were included; 530 underwent surgery before (group 1) and 595 underwent surgery after (group 2) the introduction of robotic MIS. The 5-year rate of recurrence was low: 8.2% and 6.3% (p = 0.55) in group 1 and 2, respectively. In adjusted analyses, this corresponded to a five-year disease-free survival, hazard ratio (HR) 1.23 [95% confidence interval (CI) 0.79-1.93]. No difference in site of recurrence (P = 0.19) was observed. The cumulative cancer-specific survival was 94.1% and 95.9% (P = 0.10) in group 1 and 2, respectively, corresponding to a HR 0.60 [95% CI 0.32-1.11] in adjusted analyses.CONCLUSION: In this population-based cohort study, the Danish nationwide adoption of robotic MIS for early-stage CC was not associated with increased risk of recurrence or reduction in survival outcomes.
Databáze: OpenAIRE
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