title: Analysis of disease recurrence and survival for women with uterine malignancies undergoing robotic surgery.
abstract: OBJECTIVE
  To evaluate recurrence-free survival (RFS) and overall survival (OS) for patients who underwent robotic-assisted laparoscopic hysterectomy (RALH) for uterine malignancies.
  
  
  METHODS
  Medical records from 372 patients with uterine malignancies who underwent RALH from 3/06 to 3/09 at two institutions were reviewed for clinico-pathologic data, adjuvant therapies, disease recurrence, and survival. Median follow-up for survival analysis was 31 ± 14 months. Thirty (8.1%) patients were lost to follow-up before 12 months and censored from the recurrence analysis.
  
  
  RESULTS
  Mean age and BMI of 372 patients was 61.8 ± 9.8 years and 32.2 ± 8.4 kg/m(2) (range 19-70). Robotic procedures included RALH 16 (4.3%), RALH with pelvic lymphadenectomy (PL) 96 (25.8%), and RALH with pelvic-and-aortic lymphadenectomy (PAL) 252 (67.7%) cases. Histology included 319 (85.8%) endometrioid and 53 (12.6%) high-risk histologies. Mean pelvic and aortic lymph node counts were 16.8 ± 8.7 and 8.4 ± 4.5, respectively. Lymph node metastases were identified in 26 (7.3%) cases. Adjuvant therapies were prescribed for 108 (29.1%) of patients: 7.8% brachytherapy, 1.9% pelvic radiation+brachytherapy, 7.8% chemotherapy, 11.6% chemotherapy+radiation. Risk of recurrence for all patients was 8.3% and 17 (4.6%) patients died of disease. The estimated 3-year recurrence-free survival (RFS) for the entire study group was 89.3% and the estimated 5-year overall survival (OS) was 89.1%, compared to 92.5% and 93.4% for the endometrioid sub-set.
  
  
  CONCLUSIONS
  Patients with endometrial cancer undergoing robotic hysterectomy with staging lymphadenectomies during our 3-years of robotic experience had low-risk for recurrence and excellent disease-specific survival at a median follow-up time of 31 months.
authors.affiliation: Florida Hospital Cancer Institute, Florida Hospital Gynecologic Oncology, Orlando, FL 32804, USA. lorna.brudie@yahoo.com
authors.forename: Lorna A
authors.initials: LA
authors.lastname: Brudie
authors.forename: Floor J
authors.initials: FJ
authors.lastname: Backes
authors.forename: Sarfraz
authors.initials: S
authors.lastname: Ahmad
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhu
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Finkler
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Bigsby
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
authors.forename: David
authors.initials: D
authors.lastname: O'Malley
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Fowler
authors.forename: Robert W
authors.initials: RW
authors.lastname: Holloway
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D012371:Robotics / Q000379:methods; D015996:Survival Rate; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult