Robotic radical hysterectomy versus open radical hysterectomy for cervical cancer: a single-centre experience from India

Abstract

To compare the disease-free survival (DFS) and overall survival (OS) at 3 years and 5 years in patients undergoing treatment for early-stage cervical cancer with either robotic (RRH) or open radical hysterectomy (ORH). This retrospective study compared all patients with stage IA1 (lymphovascular invasion), IA2, IB1, IB2 and II A cervical cancer in accordance with International Federation of Gynaecology and Obstetrics staging (FIGO 2009) of cancer of the cervix uteri. Patients who underwent Radical Hysterectomy at our centre from January 2011 till January 2018 were included in the study. One hundred and eighty-nine patients ( ORH\u2009=\u200967, RRH\u2009=\u2009122) were included. The median follow-up time was 46.3 months in RRH group and 70.0 months in the ORH group. The 3-year DFS was comparable in both the arms, 91.5% in RRH and 91.6% in ORH. The 5-year DFS was 88.9% and 85.9% in robotic and open approaches, respectively (P\u2009=\u20090.258), hazard ratio (HR) 0.616 (CI\u2009=\u20090.266–1.427). The 3-year overall survival for robotic approach was 93.4% and for open was 95%, whereas 5-year overall survival was 84.7% and 87.4% in robotic and open approaches, respectively (P\u2009=\u20090.813). The median estimated blood loss for robotics was lower (100 ml vs 300 ml, P\u2009<\u20090.001) and median operative time was less (162.5 min vs. 180 min, P\u2009=\u20090.005) in robotics. The patients in RRH cohort had shorter median hospital stay (3.9 days vs. 6.3 days, P\u2009<\u20090.001). Robotic radical hysterectomy had comparable survival outcomes to open radical hysterectomy in cancer cervix. RRH is associated with improved peri-operative surgical outcomes and better resource utilisation.