Comparison of the Long-Term Oncological Outcomes Between the Initial Learning Period of Robotic and the Experienced Period of Laparoscopic Radical Hysterectomy for Early-Stage Cervical Cancer.

ABSTRACT

OBJECTIVES: To compare the long-term oncological outcomes, complication rates, and recurrence patterns of robotic radical hysterectomy (RRH) with laparoscopic radical hysterectomy (LRH) for the treatment of early-stage cervical cancer. METHODS: Between January 2008 and December 2013, 65 consecutive patients underwent RRH during the learning period, and 60 consecutive patients underwent LRH during the experienced period. RESULTS: Both groups were similar with respect to clinicopathologic characteristics. The mean operative time in the RRH group was significantly longer than that in the LRH group (277.8 ± 57.3 vs 199.6 ± 45.0 minutes; P < 0.0001). Postoperative complication rates were significantly higher in the RRH group than in the LRH group (47.7% vs 27.1%; P = 0.0188). No difference in the estimated disease-free survival rates was observed between the 2 groups (P = 0.3152); however, the estimated overall survival of RRH was lower than that of LRH with marginal significance (P = 0.0762). There was no significant difference in terms of recurrence pattern between the 2 groups (P = 0.7041). However, peritoneal recurrences occurred only in the RRH group. CONCLUSIONS: Despite RRH being performed by an experienced laparoscopic oncologist, RRH showed inferior long-term oncological outcomes and postoperative complication rates compared with those of LRH during the learning period.