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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

Alfonzo, Emilia ; Wallin, Emelie ; Ekdahl, Linnea LU orcid ; Staf, Christian ; Rådestad, Angelique Flöter ; Reynisson, Petur LU ; Stålberg, Karin ; Falconer, Henrik ; Persson, Jan LU and Dahm-Kähler, Pernilla (2019) In European Journal of Cancer 116. p.169-177
Abstract

Purpose: The aim of the study was to compare overall survival (OS) and disease-free 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... (More)

Purpose: The aim of the study was to compare overall survival (OS) and disease-free 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.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cervical cancer, Disease-free survival, Radical hysterectomy, Robotic, Surgery, Survival
in
European Journal of Cancer
volume
116
pages
9 pages
publisher
Elsevier
external identifiers
  • scopus:85067016820
  • pmid:31200323
ISSN
0959-8049
DOI
10.1016/j.ejca.2019.05.016
project
Robot-assisted laparoscopic surgery for early stage cervical cancer
language
English
LU publication?
yes
id
d6782998-11ed-43fe-9677-21ab5174191f
date added to LUP
2019-06-26 13:39:17
date last changed
2024-06-11 18:03:11
@article{d6782998-11ed-43fe-9677-21ab5174191f,
  abstract     = {{<p>Purpose: The aim of the study was to compare overall survival (OS) and disease-free 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 &lt; 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.</p>}},
  author       = {{Alfonzo, Emilia and Wallin, Emelie and Ekdahl, Linnea and Staf, Christian and Rådestad, Angelique Flöter and Reynisson, Petur and Stålberg, Karin and Falconer, Henrik and Persson, Jan and Dahm-Kähler, Pernilla}},
  issn         = {{0959-8049}},
  keywords     = {{Cervical cancer; Disease-free survival; Radical hysterectomy; Robotic; Surgery; Survival}},
  language     = {{eng}},
  pages        = {{169--177}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Cancer}},
  title        = {{No survival difference between robotic and open radical hysterectomy for women with early-stage cervical cancer : results from a nationwide population-based cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.ejca.2019.05.016}},
  doi          = {{10.1016/j.ejca.2019.05.016}},
  volume       = {{116}},
  year         = {{2019}},
}