title: Feasibility of robotic radical hysterectomy after neoadjuvant chemotherapy in women with locally advanced cervical cancer.
abstract: OBJECTIVE
  To evaluate the safety and feasibility of robotic radical hysterectomy (RRH) in women with locally advanced cervical cancer (LACC) after neoadjuvant chemotherapy (NACT).
  
  
  METHODS
  A retrospective comparative longitudinal observational study was performed in 30 patients with LACC FIGO stage IB2-IIB who underwent RRH after NACT between February 2008 and September 2014. This group was compared with a cohort of 176 patients underwent RRH with cervical cancer FIGO stage IA2-IB1 in the same period of time.
  
  
  RESULTS
  Patients' age, BMI, ASA score, comorbidity, and previous abdominal surgery, was similar between groups. FIGO stage significantly differed between groups; 29 (96.6%) of patients had FIGO stage IB2 in NACT group and 163 (92.6%) were FIGO stag IB1 in women without NACT, p < 0.001. Type of RRH was also significantly different between groups. Type C1 RRH was significantly more common in NACT group, p = 0.015. Mean (SD) tumor size was significantly bigger in NACT, 27.0 (13.7) mm versus 20.9 (9.0) mm in early stage versus LACC, respectively. p = 0.023. Mean (SD) surgical time was significantly longer in NACT group (307.8 (40.2) min versus 277.4 (45.4) min, p = 0.001). Estimated blood loss and length of the hospital stay were similar between groups. There were no significant differences in terms of intraoperative and postoperative complications.
  
  
  CONCLUSIONS
  RRH after NACT in women with LACC seems to be safe and feasible. These results need to be confirmed in studies with a larger patients sample.
authors.affiliation: Gynecology Department, Valencian Institute of Oncology (IVO), Valencia, Spain. Electronic address: miniglucas@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Minig
authors.affiliation: Gynecology Department, European Institute of Oncology (IEO), Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Zanagnolo
authors.affiliation: Department of Applied Mathematics and Statistics CEU San Pablo University, Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Cárdenas-Rebollo
authors.affiliation: Gynecology Department, European Institute of Oncology (IEO), Milan, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Colombo
authors.affiliation: Gynecology Department, European Institute of Oncology (IEO), Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Maggioni
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D015251:Epirubicin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007069:Ifosfamide / Q000627:therapeutic use; D008137:Longitudinal Studies; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D043823:Taxoids / Q000627:therapeutic use; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D043823:Taxoids; D015251:Epirubicin; D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide
keywords: Abdominal radical hysterectomy; Cervical cancer; Complications; Neoadjuvant chemotherapy; Robotic radical hysterectomy