title: Robotic Versus Open Radical Hysterectomy in Women With Locally Advanced Cervical Cancer After Neoadjuvant Chemotherapy: A Single-institution Experience of Surgical and Oncologic Outcomes.
abstract: To compare the surgical and oncologic outcomes of robotic radical hysterectomy (RRH) versus laparotomy in women with locally advanced cervical cancer (LACC) after neoadjuvant chemotherapy (NACT).
  
  
  
  Oncology referral center.
  
  
  
  A retrospective comparative observational study was performed in 30 patients with LACC Fédération Internationale de Gynécologie et d'Obstétrique stage IB2-IIB who underwent RRH after NACT between February 2008 and December 2014. This group was compared with a cohort of 44 patients with similar characteristics who underwent abdominal radical hysterectomy after NACT (Canadian Task Force classification II2).
  
  
  
  Patients with LACC FIGO stage IB2-IIB.
  
  
  
  A retrospective comparative observational study.
  
  
  
  The mean (standard deviation [SD]) operative time was significantly longer in the robotic group (307.8 minutes [40.2] vs 233.7 minutes [61.9], p ≤ .001). On the contrary, the mean (SD) estimated blood loss was significantly lower in the robotic group (111.0 mL [69.6] vs 286.9 mL [159.1], p ≤ .001), and length of stay was significantly shorter (4.1 [2.4] days vs 5.8 days [3.3], p = .015). The incidence of intraoperative and early and late complications was not statistically significantly different between the 2 groups. The mean (SD) follow-up of patients was 35.6 months (28.4) and 43.7 months (23.2) in the open and robotic groups, respectively (p = .137). The disease recurrence rate (27.2% vs 20%) was similar between the 2 groups; sites and types of recurrences were also similar. Kaplan-Meier survival analysis for median progression-free survival and median overall survival were not statistically different comparing cohorts by surgery type.
  
  
  
  RRH after NACT in women with LACC is associated with similar perioperative and oncologic outcomes to open procedure. These results require further investigation to establish a more robust conclusion.
authors.affiliation: Gynecology Department, European Institute of Oncology, Milan, Italy. Electronic address: vanna.zanagnolo@ieo.it.
authors.forename: Vanna
authors.initials: V
authors.lastname: Zanagnolo
authors.affiliation: Gynecology Department, Valencian Institute of Oncology, Valencia, Spain.
authors.forename: Lucas
authors.initials: L
authors.lastname: Minig
authors.affiliation: Department of Applied Mathematics and Statistics, CEU San Pablo University, Madrid, Spain.
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Cárdenas-Rebollo
authors.affiliation: Gynecology Department, European Institute of Oncology, Milan, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Achilarre
authors.affiliation: Gynecology Department, European Institute of Oncology, Milan, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Garbi
authors.affiliation: Italian Hospital of San Justo, Buenos Aires, Argentina.
authors.forename: Maria Guadalupe
authors.initials: MG
authors.lastname: Patrono
authors.affiliation: Gynecology Department, European Institute of Oncology, Milan, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Colombo
authors.affiliation: Gynecology Department, European Institute of Oncology, Milan, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Maggioni
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007813:Laparotomy; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D061646:Operative Time; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*
keywords: Abdominal radical hysterectomy; Complications; Locally advanced cervical cancer; Neoadjuvant chemotherapy; Robotic radical hysterectomy