Risk Factors for Recurrence after Robot-Assisted Radical Hysterectomy for Early-Stage Cervical Cancer: A Multicenter Retrospective Study

Cancers

Antonio Gil-Moreno¹  Henrique Nabais²  Juan Gilabert-Estelles³  Sergio Martínez-Román⁴  Anna Taltavull⁵  Ginés Hernández⁶  MaríaÁngeles Martínez-Maestre⁷  Jesús De la Rosa⁸  Jordi Ponce⁹  Sergi Fernandez-Gonzalez⁹  Marc Barahona⁹  Manel Barahona^1,10  PluvioJ. Coronado^1,11 

[1] Department of Gynecologic Oncology, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain;Department of Gynecology, Champalimaud Foundation, 1400-038 Lisbon, Portugal;Department of Gynecology, Hospital General Universitario de Valencia, University of Valencia, 46014 Valencia, Spain;Department of Gynecology, Hospital Universitari Germans Trias i Pujol, Badalona, 08916 Barcelona, Spain;Department of Gynecology, Hospital Universitari Josep Trueta, 17007 Girona, Spain;Department of Gynecology, Hospital Universitario Quirónsalud, 28223 Madrid, Spain;Department of Gynecology, Hospital Universitario Virgen del Rocio, 41013 Sevilla, Spain;Department of Gynecology, Hospital Universitario de Basurto, 48013 Bilbao, Spain;Department of Gynecology, University Hospital of Bellvitge (IDIBELL), L’Hospitalet de Llobregat, 08907 Barcelona, Spain;Department of Gynecology, University Hospital of Puerto Real, 11510 Cádiz, Spain;Instituto de Salud de la Mujer, Hospital Clínico San Carlos, Madrid, IdISSC, Universidad Complutense, 28040 Madrid, Spain;

关键词: early-stage cervical cancer;    robotic surgery;    radical hysterectomy;    oncological outcome;    recurrence;   

DOI  :  10.3390/cancers12113387

来源: DOAJ

【 摘 要 】

This retrospective analysis aimed to assess the risk factors for recurrence in patients diagnosed with early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009) undergoing robot-assisted radical hysterectomy in Spain and Portugal between 2009 and 2018. A second primary objective was to audit the oncological outcomes according to quality indicators (QI) proposed by the European Society of Gynecology Oncology (ESGO). The study population included 239 women. After a median follow-up of 51 months, recurrence occurred in 26 patients (10.9%). Independent factors for recurrence were clinical tumor size > 20 mm (hazard ratio (HR) 2.37), adenocarcinoma as histological type (HR 2.51), positive pelvic lymph nodes (HR 4.83), tumor grade 2 (HR 4.99), tumor grade 3 (HR 8.06), and having not performed sentinel lymph node biopsy (SLNB) (HR 4.08). All 5 QI selected were surpassed by our results. In patients with early-stage cervical cancer undergoing robotic radical hysterectomy, clinicians should be aware that tumor grade 2 and 3, tumor size > 20 mm, adenocarcinoma, positive pelvic nodes, and lack of performance of SLNB are risk factors for recurrence. Fulfillment of QI targets of the ESGO might be considered as an objective oncological outcome indicator supporting the minimally invasive approach for early-stage cervical cancer treatment.

【 授权许可】

Unknown