title: Surgical outcomes of robotic radical hysterectomy after neoadjuvant chemotherapy for locally advanced cervical cancer: comparison with early stage disease.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Gynecology, Cancer Center, IRCCS Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Vitobello
authors.forename: G
authors.initials: G
authors.lastname: Siesto
authors.forename: C
authors.initials: C
authors.lastname: Pirovano
authors.forename: N
authors.initials: N
authors.lastname: Ieda
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D019583:Dose Fractionation, Radiation; D015251:Epirubicin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D007069:Ifosfamide / Q000008:administration & dosage; D010535:Laparoscopy; D008197:Lymph Node Excision; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012371:Robotics; D012449:Safety; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D014621:Vagina
chemical_list: D015251:Epirubicin; D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide