Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of North Carolina, Chapel Hill, NC 27599-7572, USA.
Gynecol Oncol. 2010 May;117(2):260-5. doi: 10.1016/j.ygyno.2010.01.012. Epub 2010 Feb 13.
OBJECTIVES.: To assess progression-free (PFS) and overall survival (OS) for women with cervical cancer who underwent type III robotic radical hysterectomy (RRH). METHODS.: A retrospective analysis of women who underwent RRH from 2005 to 2008 was performed. The data analyzed included patient demographics, histology, clinical stage, surgical margins, lymph node and disease status. Comparison was made to a group of historical open radical hysterectomies. Survival statistics were analyzed using the Kaplan-Meier method. RESULTS.: Seventy-one women underwent attempted RRH during the study period. Eight were excluded from analysis, 4 for non-cervical primary and 4 cases aborted due to extent of disease. Squamous was the most common histology (62%) followed by adenocarcinoma (32%). Median patient age was 43 years. There was one intraoperative complication (asystole after induction) and two postoperative complications (ICU admission to rule out myocardial infarction and reoperation for cuff dehiscence). Of the patients who underwent RRH, 32% received whole-pelvis radiation with chemo sensitization. The median follow-up was 12.2 months (range 0.2-36.3 months). Kaplan-Meier survival analysis demonstrated 94% PFS and OS at 36 months due to the recurrence and death of one patient. Compared with a historical cohort at our institution, there was no statistically significant difference in PFS (P=0.27) or OS (P=0.47). CONCLUSIONS.: RRH is safe and feasible and has been shown to be associated with improved operative measures. This study shows that at 3 years, RRH appears to have PFS and OS equivalent to that of traditional laparotomy. Longer follow-up is needed, but early data are supportive of at least equivalent oncologic outcomes compared with other surgical modalities.
评估接受 III 型机器人根治性子宫切除术（RRH）的宫颈癌女性患者的无进展生存期（PFS）和总生存期（OS）。方法：对 2005 年至 2008 年接受 RRH 的女性进行回顾性分析。分析的数据包括患者人口统计学、组织学、临床分期、手术切缘、淋巴结和疾病状态。与一组历史上的开放性根治性子宫切除术进行比较。使用 Kaplan-Meier 方法分析生存统计数据。结果：在研究期间，有 71 名女性接受了尝试性 RRH。有 8 名女性因非宫颈原发性疾病而被排除在分析之外，还有 4 例因疾病程度而中止手术。最常见的组织学类型是鳞状细胞癌（62%），其次是腺癌（32%）。中位患者年龄为 43 岁。有 1 例术中并发症（诱导后心动停止）和 2 例术后并发症（入住 ICU 排除心肌梗死和再次手术修复袖口裂开）。在接受 RRH 的患者中，32%接受了全骨盆放疗联合化疗增敏。中位随访时间为 12.2 个月（范围 0.2-36.3 个月）。Kaplan-Meier 生存分析显示，由于 1 例患者复发和死亡，36 个月时 PFS 和 OS 分别为 94%。与本机构的历史队列相比，PFS（P=0.27）或 OS（P=0.47）无统计学差异。结论：RRH 安全可行，并且已经显示出与改善手术措施相关。本研究表明，在 3 年时，RRH 的 PFS 和 OS 似乎与传统的剖腹手术相当。需要更长时间的随访，但早期数据支持至少与其他手术方式相当的肿瘤学结果。
