Robotic versus total laparoscopic radical hysterectomy with pelvic lymphadenectomy for the treatment of early cervical cancer

Abstract

Background: The aim of this study is to compare the safety, morbidity, intra operative, pathologic and postoperative outcomes of Robotic radical hysterectomy (RRH) to total laparoscopic radical hysterectomy (TLRH) in patients with early stage cervical cancer.

Methods: All the women with newly diagnosed invasive cervical cancer (stage IB1to IIA), who underwent TLRH or RRH with pelvic lymph node dissection at Krishna Institute of Medical Sciences from September 2011 to August 2013 were analysed.

Results: Twenty six patients underwent TLRH with pelvic lymphadenectomy and twenty six patients underwent RRH with pelvic lymphadenectomy. Age, tumor histology, stage, lymphovascular space involvement and nodal status are same for both the groups. No statistical differences were observed in operative time (174 vs. 158 min), estimated blood loss (160 vs. 110 ml), or hospital stay (3.1 vs. 2.8 days). Mean pelvic lymph node count was more in Robotic group. None of the robotic or laparoscopic procedures required conversion to laparotomy. All patients in both groups are alive and free of disease at the time of last follow up.

Conclusions: According to our experience, robotic radical hysterectomy appears to be safe and effective therapeutic procedure for managing early-stage cervical cancer without significant differences when compared to TLRH, with respect to operative time, blood loss, hospital stay. Regarding the oncological outcome, Robotic radical hysterectomy is superior in terms of number of lymph nodes and parametrial bulk; although multicenter randomized clinical trials with longer follow-up are necessary to evaluate the overall oncologic outcome.