Emilia Alfonzo1, Emelie Wallin2, Linnea Ekdahl3, Christian Staf4, Angelique Flöter Rådestad2, Petur Reynisson3, Karin Stålberg5, Henrik Falconer2, Jan Persson3, Pernilla Dahm-Kähler6. 1. Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden; Department of Obstetrics & Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Medicinaregatan 3, 41390 Gothenburg, Sweden. 2. Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska University Hospital and Karolinska Institute, K 57 14186 Stockholm, Sweden. 3. Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology Skåne University Hospital 22185 Lund, Sweden; Lund University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology, 22185 Lund, Sweden. 4. Regional Cancer Centre Western Sweden, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden. 5. Department of Women's and Children's Health, Uppsala University, 75185 Uppsala, Sweden. 6. Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden; Department of Obstetrics & Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Medicinaregatan 3, 41390 Gothenburg, Sweden; Regional Cancer Centre Western Sweden, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden. Electronic address: pernilla.dahm-kahler@vgregion.se.
Abstract
PURPOSE: The aim of the study was to compare overall survival (OS) and disease-free survival (DFS) after open and robotic radical hysterectomy for early-stage cervical cancer. PATIENTS AND METHODS: This was a nationwide population-based cohort study on all women with cervical cancer stage IA1-IB of squamous, adenocarcinoma or adenosquamous histological subtypes, from January 2011 to December 2017, for whom radical hysterectomy was performed. The Swedish Quality Register of Gynaecologic Cancer was used for identification. To ensure quality and conformity of data and to disclose patients not yet registered, hospital registries were reviewed and validated. Cox and propensity score regression analysis and univariable and multivariable regression analysis were performed in regard to OS and DFS. RESULTS: There were 864 women (236 open and 628 robotic) included in the study. The 5-year OS was 92% and 94% and DFS was 84% and 88% for the open and robotic cohorts, respectively. The recurrence pattern was similar in both groups. Using propensity score analysis and matched cohorts of 232 women in each surgical group, no significant differences were seen in survival: 5-year OS of 92% in both groups (hazard ratio [HR], 1.00; 95% confidence interval [CI], 0.50-2.01) and DFS of 85% vs 84% in the open and robotic cohort, respectively (HR, 1.08; 95% CI, 0.66-1.78). In univariable and multivariable analysis with OS as the end-point, no significant factors were found, and in regard to DFS, tumour size (p < 0.001) and grade 3 (p = 0.02) were found as independent significant risk factors. CONCLUSION: In a complete nationwide population-based cohort, where radical hysterectomy for early-stage cervical cancer is highly centralised, neither long-term survival nor pattern of recurrence differed significantly between open and robotic surgery.
PURPOSE: The aim of the study was to compare overall survival (OS) and disease-free survival (DFS) after open and robotic radical hysterectomy for early-stage cervical cancer. PATIENTS AND METHODS: This was a nationwide population-based cohort study on all women with cervical cancer stage IA1-IB of squamous, adenocarcinoma or adenosquamous histological subtypes, from January 2011 to December 2017, for whom radical hysterectomy was performed. The Swedish Quality Register of Gynaecologic Cancer was used for identification. To ensure quality and conformity of data and to disclose patients not yet registered, hospital registries were reviewed and validated. Cox and propensity score regression analysis and univariable and multivariable regression analysis were performed in regard to OS and DFS. RESULTS: There were 864 women (236 open and 628 robotic) included in the study. The 5-year OS was 92% and 94% and DFS was 84% and 88% for the open and robotic cohorts, respectively. The recurrence pattern was similar in both groups. Using propensity score analysis and matched cohorts of 232 women in each surgical group, no significant differences were seen in survival: 5-year OS of 92% in both groups (hazard ratio [HR], 1.00; 95% confidence interval [CI], 0.50-2.01) and DFS of 85% vs 84% in the open and robotic cohort, respectively (HR, 1.08; 95% CI, 0.66-1.78). In univariable and multivariable analysis with OS as the end-point, no significant factors were found, and in regard to DFS, tumour size (p < 0.001) and grade 3 (p = 0.02) were found as independent significant risk factors. CONCLUSION: In a complete nationwide population-based cohort, where radical hysterectomy for early-stage cervical cancer is highly centralised, neither long-term survival nor pattern of recurrence differed significantly between open and robotic surgery.
Authors: Roni Nitecki; Pedro T Ramirez; Michael Frumovitz; Kate J Krause; Ana I Tergas; Jason D Wright; J Alejandro Rauh-Hain; Alexander Melamed Journal: JAMA Oncol Date: 2020-07-01 Impact factor: 31.777
Authors: Koji Matsuo; Shinya Matsuzaki; Rachel S Mandelbaum; Erica J Chang; Maximilian Klar; Kazuhide Matsushima; Brendan H Grubbs; Lynda D Roman; Jason D Wright Journal: Gynecol Oncol Date: 2020-05-27 Impact factor: 5.482
Authors: Benny Brandt; Vasileios Sioulas; Derman Basaran; Theresa Kuhn; Katherine LaVigne; Ginger J Gardner; Yukio Sonoda; Dennis S Chi; Kara C Long Roche; Jennifer J Mueller; Elizabeth L Jewell; Vance A Broach; Oliver Zivanovic; Nadeem R Abu-Rustum; Mario M Leitao Journal: Gynecol Oncol Date: 2020-01-07 Impact factor: 5.482