Acta obstetricia et gynecologica Scandinavica vol:92 issue:8 pages:895-901
OBJECTIVES: FIGO classification is commonly used for staging of locally advanced cervical cancer. Laparoscopic para-aortic lymphadenectomy is currently used as a diagnostic tool, since we know that presence of para-aortic lymph node metastases identifies patients with poor prognosis. Robotics application during this procedure needs to be investigated. DESIGN: Retrospective multi-center study. SETTING: Three centers participated in building one database. POPULATION: 37 patients with locally advanced cervical cancer underwent a robot-assisted laparoscopic para-aortic lymphadenectomy METHODS: Patients were prospectively enrolled in one register. Retrospective analysis of the whole database was performed. MAIN OUTCOME MEASURES: Surgical outcomes of the robot-assisted procedure and follow-up data. RESULTS: Median number of lymph nodes collected was 27.5 (1-54) per patient. Five of 37 patients had para-aortic node metastases. The false negative rate for PET-CT diagnosing para-aortic node metastases was 11.4% (4/35). Two major intra operative complications occurred (5.4%). Post-operative morbidity was low (13.5%). Median follow-up was 27 months (95% confidence interval 24-30). Median disease-free survival was 16 months (95% confidence interval 2.4-29.6). Patients with negative nodes had a median disease-free survival of 24 months (not assessable), although patients with positive nodes had a median disease-free survival of nine months (95% confidence interval 6.9-11.9). CONCLUSIONS: In this series we report that robot-assisted laparoscopic para-aortic lymphadencetomy provided the surgeon with useful information, diagnosing 11.4% of occult para-aortic lymph node metastases in women with locally advanced cervical cancer. Intra-operative and post-operative morbidity were low. Presence of para-aortic lymph node metastases correlated with shorter disease-free survival. This article is protected by copyright. All rights reserved.