Comparison of the Long-Term Oncological Outcomes Between the Initial Learning Period of Robotic and the Experienced Period of Laparoscopic Radical Hysterectomy for Early-Stage Cervical Cancer.

Abstract

To compare the long-term oncological outcomes, complication rates, and recurrence patterns of robotic radical hysterectomy (RRH) with laparoscopic radical hysterectomy (LRH) for the treatment of early-stage cervical cancer. Between January 2008 and December 2013, 65 consecutive patients underwent RRH during the learning period, and 60 consecutive patients underwent LRH during the experienced period. Both groups were similar with respect to clinicopathologic characteristics. The mean operative time in the RRH group was significantly longer than that in the LRH group (277.8 ± 57.3 vs 199.6 ± 45.0 minutes; P < 0.0001). Postoperative complication rates were significantly higher in the RRH group than in the LRH group (47.7% vs 27.1%; P = 0.0188). No difference in the estimated disease-free survival rates was observed between the 2 groups (P = 0.3152); however, the estimated overall survival of RRH was lower than that of LRH with marginal significance (P = 0.0762). There was no significant difference in terms of recurrence pattern between the 2 groups (P = 0.7041). However, peritoneal recurrences occurred only in the RRH group. Despite RRH being performed by an experienced laparoscopic oncologist, RRH showed inferior long-term oncological outcomes and postoperative complication rates compared with those of LRH during the learning period.