title: Surgical and Oncological Outcome of Robotic Surgery Compared With Laparoscopic and Abdominal Surgery in the Management of Locally Advanced Cervical Cancer After Neoadjuvant Chemotherapy.
abstract: OBJECTIVE
  The primary aim is to evaluate the surgical and oncological outcome of robotic radical hysterectomy (RRH) plus pelvic lymphadenectomy in locally advanced cervical cancer (LACC) after neoadjuvant chemotherapy (NACT). The secondary aim is to compare the surgical and oncological results of RRH after NACT with a historical cohort of patients undergoing laparoscopic radical hysterectomy or abdominal radical hysterectomy plus pelvic lymphadenectomy for LACC after NACT.
  
  
  METHODS
  We enrolled a total of 41 patients in this study with LACC undergoing RRH, who achieved a clinical partial or complete response to NACT. The surgical and oncological outcomes of 2 historical groups were compared: the laparoscopic group (41 patients) with the laparotomic group (43 patients).
  
  
  RESULTS
  The median estimated blood loss, operative time, and length of hospital stay were statistically significant and in favor of the robotic group. No conversion to laparotomy in the robotic group was necessary. There were no significant differences between the 3-year overall survival and disease-free survival rates in the minimally invasive groups; nevertheless, the robotic group showed the same recurrence rate of laparoscopic in a short-interval follow-up.
  
  
  CONCLUSIONS
  The robotic approach could be considered a feasible and safe alternative to other surgical options. Multicenter randomized clinical trials with longer follow-ups are necessary to evaluate the overall oncologic outcomes of this procedure.
authors.affiliation: *Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute; †Department of Surgery, Section of Gynaecology and Obstetrics, Tor Vergata University of Rome; and ‡Division of Medical Oncology B and §Scientific Direction, "Regina Elena" National Cancer Institute, Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Corrado
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cutillo
authors.forename: Maria
authors.initials: M
authors.lastname: Saltari
authors.forename: Emanuela
authors.initials: E
authors.lastname: Mancini
authors.forename: Stefano
authors.initials: S
authors.lastname: Sindico
authors.forename: Patrizia
authors.initials: P
authors.lastname: Vici
authors.forename: Domenico
authors.initials: D
authors.lastname: Sergi
authors.forename: Isabella
authors.initials: I
authors.lastname: Sperduti
authors.forename: Lodovico
authors.initials: L
authors.lastname: Patrizi
authors.forename: Giulia
authors.initials: G
authors.lastname: Pomati
authors.forename: Ermelinda
authors.initials: E
authors.lastname: Baiocco
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizza
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D061646:Operative Time; D010388:Pelvis / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*