Five year survival surgical outcome for clinic stage I cervical cancer: Comparison of robotic vs. laparoscopic or laparotomy radical hysterectomy

Abstract

Objectives: To determine if there is a difference in 5-year survival between robotic versus laparoscopic versus open radical hysterectomy in the treatment of clinical stage I cervical cancer. Methods: Retrospective case-matched cohort study was undertaken from 1999 to 2014. Age, subset of stage I, histology and tumor grade in the cohort, and robotic, laparoscopic, and open radical hysterectomy were analyzed. Overall survival for surgical treatment for stage I cervical cancer was analyzed. The 5-year survival for each respective surgical treatment was analyzed to determine if there was difference among robotic, laparoscopic and radical hysterectomy. Results: During the period 1999 to 2014, 110 patients underwent radical hysterectomy with bilateral pelvic lymphadenectomy (RHBPLND) for clinical stage I cervical cancer. From 1999 to 2008, 28 (25.5%) patients underwent open RHBPLND (ORHBPLND), and (30.9%) patients underwent laparoscopic radical hysterectomy with pelvic lymphadenectomy (LRHBPLND). From 2008 to 2015, 48 (43.6%) patients underwent robotic radical hysterectomy with bilateral pelvic lymphadenectomy (RoRHBPLND). Of those who underwent robotic surgery, 25% were stage 1a2, 47.9 % were stage 1B1, and 10.4% stage IB2. The overall 5-year survival was 87.5%. The 5-year survival for robotic, laparoscopic, and open surgical cohorts were 87.5%, 96.9%, and 82.1%, respectively. There was no difference in 5 -ear survival for stage IA2, IB1, and IB2 for all 3 surgical procedures. We also reviewed histology, grade, and parametrial as well as vaginal cuff measurements in all 3 groups. Conclusions: The overall 5-year survival for RoRHBPLND for treatment of clinical stage I cervical is 87.5%. There was no difference in 5-year survival among RoRHBPLND, LRHBPLND, and ORHBPLND.