Long-term oncological outcome in patients with cervical cancer after 3 trimodality treatment (radiotherapy, platinum-based chemotherapy, and robotic surgery)

Abstract

Cervical cancer represents a general health issue spread all over the globe, which prompts the surge of scientific survey toward the rise of survival and condition of life of these patients. American and European guidelines suggest the open surgery, laparoscopic, and robotic surgery are the main therapeutic approaches for radical hysterectomy for patients with cervical cancer. This is the first survey to analyze the long-term oncological outcome of an extensive series of subjects cared for with multimodality treatment, here comprising robotic surgery. This study intents to evaluate the long-term oncological result in patients diagnosed with cervical cancer treated with radiotherapy (±chemotherapy) and robotic surgery compared with open surgery. Medical files of 56 patients diagnosed with cervical cancer who underwent a robotic hysterectomy and radiotherapy ± chemotherapy were retrospectively analyzed. The median age at diagnosis was 50.5 (range: 23–70). Eleven patients (19.6%) presented in an early stage (IB–IIA) and 80.4% advanced stage (IIB–IVA). Overall response rate after radiotherapy and chemoradiotherapy was 96.2%. Pathologic complete response was obtained in 64% of patients. After a median follow-up of 60 months (range: 6–105 months), 8 patients (14.2%) presented local recurrence or distant metastases. Disease-free survival (DFS) was 92% at 2 years and 84% at 3 and 5 years. Overall survival (OS) rates at 2, 3, and 5 years for patients with robotic surgery were 91%, 78%, and 73%, median OS not reached. OS was lower in the arm of open surgery (2, 3, and 5 years 87%, 71%, and 61%, respectively; median OS was 72 months P = .054). The multivariate analysis regarding the outcome of patients revealed an advantage for complete versus partial response ( P < .002), for early versus advanced stages ( P = .014) and a 10% gained in DFS at 3 years for patients in whom chemoradiotherapy was administered (DFS at 3 years 75% vs 85%) in patients with advanced stages. Robotic surgery has a favorable oncological outcome when associated with multimodal therapy.

Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma

“…Despite using new therapeutic agents and developing new treatment techniques, the outcome for patients with gynecological tumors remains poor, especially in developing countries [ 1 , 3 ]. Correctly identifying prognostic factors in ovarian cancer is vital, supporting the clinician in classifying the patient in a specific risk group and estimating the risk of disease progression and death.…”

“…More than two-thirds of patients are diagnosed in the advanced stages of the disease because of unspecific symptoms and a lack of efficient screening and detection methods [ 2 ]. Despite adopting new treatment techniques and developing new therapeutic agents, the outcome for patients with gynecological tumors remains poor, especially in developing countries [ 1 , 3 , 4 ].…”

Beyond Sentinel Lymph Node: Outcomes of Indocyanine Green-Guided Pelvic Lymphadenectomy in Endometrial and Cervical Cancer

“…A possible alternative to laparoscopic surgery could also be robotic surgery [ 55 , 56 , 57 , 58 ]. However, current evidence on this approach is not robust enough to draw a firm conclusion, and trials on this issue should be encouraged.…”

Effects of Brachytherapy on Quality of Life and Functionality in the Treatment of Cervix Cancer

“…Advances in health technologies have allowed the implementation of techniques that aim at improving the overall survival rates and progression-free survival among these patients, with antineoplastic chemotherapy, radiotherapy and surgery as the main forms of treatment, which can be performed individually or concomitantly 3 .…”