Radical hysterectomy after neoadjuvant chemotherapy for locally bulky-size cervical cancer: A retrospective comparative analysis between the robotic and abdominal approaches

Chia Hao Liu, Yu Chieh Lee, Jeff Chien Fu Lin, I. San Chan, Na Rong Lee, Wen Hsun Chang, Wei Min Liu, Peng Hui Wang

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1 Citation (Scopus)

Abstract

Radical hysterectomy (RH) is the standard treatment for early stage cervical cancer, but the surgical approach for locally bulky-size cervical cancer (LBS-CC) is still unclear. We retrospectively compared the outcomes of women with LBS-CC treated with neoadjuvant chemotherapy (NACT) and subsequent RH between the robotic (R-RH) and abdominal approaches (A-RH). Between 2012 and 2014, 39 women with LBS-CC FIGO (International Federation of Gynecology and Obstetrics) stage IB2–IIB were treated with NACT-R-RH (n = 18) or NACT-A-RH (n = 21). Surgical parameters and prognosis were compared. Patient characteristics were not significantly different between the groups, but the NACT-R-RH group had significantly more patients with FIGO stage IIB disease, received multi-agent-based NACT, and had a lower percentage of deep stromal invasion than the NACT-A-RH group. After NACT-R-RH, surgical parameters were better, but survival outcomes, such as disease-free survival (DFS) and overall survival (OS), were significantly worse. On multivariate analysis, FIGO stage IIB contributed to worse DFS (p = 0.003) and worse OS (p = 0.012) in the NACT-A-RH group. Women with LBS-CC treated with NACT-R-RH have better perioperative outcomes but poorer survival outcomes compared with those treated with NACT-A-RH. Thus, patients with FIGO stage IIB LBS-CC disease might not be suitable for surgery after multi-agent-based NACT.

Original languageEnglish
Article number3833
JournalInternational journal of environmental research and public health
Volume16
Issue number20
DOIs
Publication statusPublished - Oct 2 2019

Keywords

  • Abdominal radical hysterectomy
  • Bulky
  • Cervical cancer
  • Neoadjuvant chemotherapy
  • Outcome
  • Robotic radical hysterectomy

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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