title: Robot-assisted versus open radical hysterectomy: A multi-institutional experience for early-stage cervical cancer.
abstract: OBJECTIVE
  To compare perioperative and clinico-pathological outcomes of patients with early-stage cervical cancer who underwent robot-assisted radical hysterectomy (RRH) and open radical hysterectomy (ORH).
  
  
  METHODS
  This retrospective multi-center study abstracted demographic, clinico-pathological and perioperative outcomes data from medical records of 491 cervical cancer patients treated with RRH (n = 259) ORH (n = 232) between 2005 and 2011 at two American and one Norwegian University Cancer Centres.
  
  
  RESULTS
  Mean estimated blood loss (EBL) and transfusion rates were less for RRH than for ORH (97 vs. 49 mL, p < 0.001, and 3% vs. 7%, p = 0.018, respectively). Mean length of hospital stay (LOS) was significantly shorter in RRH versus ORH (1.8 vs. 5.1 days, p < 0.001). Mean operative time was longer for RRH than ORH (220 vs. 156 min, p < 0.001). Although overall complications were similar (p = 0.49), intra-operative complications were less common in the RRH group than ORH (4% vs. 10%, p = 0.004). In multivariate regression analyses longer operative time, less EBL and intra-operative complications, shorter LOS, and more pre-operative cone were significantly associated with RRH versus ORH. Recurrence and death rates were not statistically different for the two groups at a mean follow-up time of 39 months (p = 1.00 and p = 0.48, respectively).
  
  
  CONCLUSIONS
  RRH had improved clinical outcomes compared to ORH in the treatment of early-stage cervical cancer in terms of EBL, intra-operative complications, transfusion rates, LOS, and pre-operative cone. Disease recurrence and survival were comparable for the two procedures.
authors: Department of Gynecological Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway. Electronic address: sbi@ous-hf.no.
authors: B M
authors: BM
authors: Sert
authors: Department of Gynecologic Oncology, University of North Carolina, Chapel Hill, NC, USA.
authors: J F
authors: JF
authors: Boggess
authors: Department of Gynecologic Oncology, Florida Hospital Cancer Institute, Orlando, FL, USA.
authors: S
authors: S
authors: Ahmad
authors: Department of Gynecologic Oncology, University of North Carolina, Chapel Hill, NC, USA; Division of Gynecological Oncology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
authors: A L
authors: AL
authors: Jackson
authors: Department of Gynecologic Oncology, Florida Hospital Cancer Institute, Orlando, FL, USA.
authors: N M
authors: NM
authors: Stavitzski
authors: National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: A A
authors: AA
authors: Dahl
authors: Department of Gynecologic Oncology, Florida Hospital Cancer Institute, Orlando, FL, USA.
authors: R W
authors: RW
authors: Holloway
mesh_terms: D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D015994:Incidence; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000601:surgery*
keywords: Cervical cancer; Early-stage; Intra-operative complications; Morbidity; Open radical hysterectomy; Recurrence; Robotic radical hysterectomy; Survival