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

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 oncolog...

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Bibliographic Details
Published in:Cancers 2020-11, Vol.12 (11), p.3387
Main Authors: Ponce, Jordi, Fernandez-Gonzalez, Sergi, Gil-Moreno, Antonio, Coronado, Pluvio J., De la Rosa, Jesús, Nabais, Henrique, Hernández, Ginés, Taltavull, Anna, Gilabert-Estelles, Juan, Martínez-Román, Sergio, Barahona, Manel, Barahona, Marc, Martínez-Maestre, María Ángeles
Format: Article
Language:English
Subjects:
Adenocarcinoma
Audits
Biopsy
Care and treatment
Cervical cancer
Cervix
Complications and side effects
Diseases
Gynecology
Hysterectomy
Laparoscopy
Lymph nodes
Lymphatic system
Oncology
Patients
Population studies
Relapse
Risk factors
Robotics
Robots
Surgery
Surgical outcomes
Tumors
Womens health
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Summary: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.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers12113387