Robotic nerve-sparing radical hysterectomy for locally advanced cervical cancer after neoadjuvant chemotherapy

Int J Gynaecol Obstet. 2015 Nov;131(2):152-5. doi: 10.1016/j.ijgo.2015.05.017. Epub 2015 Aug 4.

Abstract

Objective: To evaluate the feasibility and safety of robotic nerve-sparing radical hysterectomy for locally advanced cervical cancer (LACC).

Methods: In a retrospective study, data were analyzed for patients treated for cervical cancer at a center in Beijing, China, between December 2011 and September 2013. Patients were subdivided into those with early-stage disease (FIGO stage IA2-IB1) who were treated by robotic surgery (group 1), and those with LACC (stage IB2-IIB) who were treated by robotic surgery after neoadjuvant chemotherapy (NACT; group 2). Therapeutic outcomes and complications were compared.

Results: Group 1 included 32 patients and group 2 included 22 patients. Two patients in group 2 did not respond to NACT and did not undergo surgery. The operative outcomes and incidences of complications did not differ significantly between the two groups (P>0.05 for all). There were no differences in nodal yield, lengths of parametrium removed, or vaginal cuff length (P>0.05 for all). During a mean follow-up of 26months, no patient experienced recurrence.

Conclusion: Robotic nerve-sparing radical hysterectomy was found to be feasible and safe for LACC after NACT. A larger case series with longer follow-up data is needed to justify its widespread application.

Keywords: Cervical cancer; Neoadjuvant chemotherapy; Nerve-sparing; Pelvic lymphadenectomy; Radical hysterectomy; Robotic surgery.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chemotherapy, Adjuvant
  • China
  • Feasibility Studies
  • Female
  • Humans
  • Hysterectomy / methods*
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Organ Sparing Treatments / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Robotic Surgical Procedures / methods*
  • Treatment Outcome
  • Uterine Cervical Neoplasms / drug therapy
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*