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No survival difference between robotic and open radical hysterectomy for women with early-stage cervical cancer: results from a nationwide population-based cohort study
Sahlgrens Univ Hosp, Dept Obstet & Gynaecol, SE-41345 Gothenburg, Sweden;Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Obstet & Gynaecol, Med Gatan 3, S-41390 Gothenburg, Sweden.
Karolinska Univ Hosp, Div Obstet & Gynaecol, Dept Womens & Childrens Hlth, K 57, S-14186 Stockholm, Sweden;Karolinska Inst, K 57, S-14186 Stockholm, Sweden.
Skane Univ Hosp, Div Gynaecol Oncol, Dept Obstet & Gynaecol, S-22185 Lund, Sweden;Lund Univ, Fac Med, Dept Clin Sci Obstet & Gynaecol, S-22185 Lund, Sweden.
Sahlgrens Univ Hosp, Reg Canc Ctr Western Sweden, S-41345 Gothenburg, Sweden.
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2019 (English)In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 116, p. 169-177Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of the study was to compare overall survival (OS) and diseasefree 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. (C) 2019 The Authors. Published by Elsevier Ltd.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 116, p. 169-177
Keywords [en]
Cervical cancer, Radical hysterectomy, Robotic, Surgery, Survival, Disease-free survival
National Category
Cancer and Oncology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-390917DOI: 10.1016/j.ejca.2019.05.016ISI: 000473270800019PubMedID: 31200323OAI: oai:DiVA.org:uu-390917DiVA, id: diva2:1343204
Funder
Swedish Cancer Society, CAN2017/594Available from: 2019-08-15 Created: 2019-08-15 Last updated: 2019-08-15Bibliographically approved

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