Comparison of the Oncological Outcomes Between Robot-Assisted and Abdominal Radical Hysterectomy for Cervical Cancer Based on the New FIGO 2018 Staging System: A Multicentre Retrospective Study

Abstract

ObjectiveTo compare the 3-year oncological outcomes of robot-assisted radical hysterectomy (RRH) and abdominal radical hysterectomy (ARH) for cervical cancer.MethodsBased on the clinical diagnosis and treatment for cervical cancer in the China database, patients with FIGO 2018 stage IA with lymphovascular space invasion (LVSI)-IB2 cervical cancer disease who underwent RRH and ARH from 2004 to 2018 were included. Kaplan–Meier survival analysis was used to compare the 3-year overall survival (OS) and disease-free survival (DFS) rate between patients receiving RRH and those receiving ARH. The Cox proportional hazards model and propensity score matching were used to estimate the surgical approach-specific survival.ResultsA total of 1,137 patients with cervical cancer were enrolled in this study, including the RRH group (n = 468) and the ARH group (n = 669). The median follow-up time was 45 months (RRH group vs. ARH group: 24 vs. 60 months). Among the overall study population, there was no significant difference in 3-year OS and DFS between the RRH group and the ARH group (OS: 95.8% vs. 97.6% p = 0.244). The Cox proportional hazards analysis showed that RRH was not an independent risk factor for 3-year OS (HR: 1.394, 95% CI: 0.552–3.523, p = 0.482). However, RRH was an independent risk factor for 3-year DFS (HR: 1.985, 95% CI: 1.078–3.655 p = 0.028). After 1:1 propensity score matching, there was no significant difference in 3-year OS between the RRH group and the ARH group (96.6% vs. 98.0%, p = 0.470); however, the 3-year DFS of the RRH group was lower than that of the ARH group (91.0% vs. 96.1%, p = 0.025). The Cox proportional hazards analysis revealed that RRH was not an independent risk factor for 3-year OS (HR: 1.622, 95% CI: 0.449–5.860 p = 0.461), but RRH was an independent risk factor for 3-year DFS (HR: 2.498, 95% CI: 1.123–5.557 p = 0.025).ConclusionAmong patients with stage I A1 (LVSI +)-I B2 cervical cancer based on the FIGO 2018 staging system, RRH has a lower 3-year DFS than ARH, suggesting that RRH may not be suitable for early cervical cancer patients.

Establishment and implementation of a clinical application and research database for surgical robots in China

“…Conducting research and developing secondary evidence is made difficult by idle complications in analyzing, identifying, categorizing, and evaluating primary evidence, especially in the medical book information sector. This leaves a significant need for adequate communication and interaction between clinicians and medical information service staff, facilitating efficient and rapid generation of secondary research evidence (Li, Lin, et al, 2022; Li, Zhan, et al, 2022). The fourth type of confusion is that experienced by users.…”

“…Meanwhile, the surgical robot research literature database was established to integrate existing evidence‐based medical resources for robotic surgery treatment. This will greatly improve the efficiency of evidence‐based practice retrieval, saving as much of clinicians and managers' time as possible (Esagian et al, 2022; Li, Zhan, et al, 2022; Marcos‐Pablos et al, 2022; Niederberger & Deckert, 2022; Pacana & Siwiec, 2022; Tschann et al, 2022). Since the first da Vinci surgical robot was installed at the Gansu Provincial Hospital in January 2016, our hospital has completed more than 3000 robotic surgeries of various types, ranking among the top single‐operator surgical facilities nationally.…”