Brudie, Lorna A., Backes, Floor J., Ahmad, Sarfraz, Zhu, Xiang, Finkler, Neil J., Bigsby, Glenn E., Cohn, David E., O'Malley, David, Fowler, Jeffrey M., Holloway, Robert W.
abstract
Objectives. To evaluate recurrence-free survival (RFS) and overall survival (OS) for patients who underwent robotic-assisted laparoscopic hysterectomy (RALH) for uterine malignancies. Methods. Medical records from 372 patients with uterine malignancies who underwent RALH from 3/06 to 3/09 at two institutions were reviewed for dinico-pathologic data, adjuvant therapies, disease recurrence, and survival. Median follow-up for survival analysis was 31 +/- 14 months. Thirty (8.1%) patients were lost to follow-up before 12 months and censored from the recurrence analysis. Results. Mean age and BMI of 372 patients was 61.8 +/- 9.8 years and 32.2 +/- 8.4 kg/m(2) (range 19-70). Robotic procedures included RALH 16 (4.3%), RALH with pelvic lymphadenectomy (PL) 96 (25.8%), and RALH with pelvic-and-aortic lymphadenectomy (PAL) 252 (67.7%) cases. Histology included 319 (85.8%) endometrioid and 53 (12.6%) high-risk histologies. Mean pelvic and aortic lymph node counts were 16.8 +/- 8.7 and 8.4 +/- 4.5, respectively. Lymph node metastases were identified in 26 (7.3%) cases. Adjuvant therapies were prescribed for 108 (29.1%) of patients: 7.8% brachytherapy, 1.9% pelvic radiation + brachytherapy, 7.8% chemotherapy, 11.6% chemotherapy + radiation. Risk of recurrence for all patients was 8.3% and 17 (4.6%) patients died of disease. The estimated 3-year recurrence-free survival (RFS) for the entire study group was 89.3% and the estimated 5-year overall survival (OS) was 89.1%, compared to 92.5% and 93.4% for the endometrioid sub-set. Conclusions. Patients with endometrial cancer undergoing robotic hysterectomy with staging lymphade-nectomies during our 3-years of robotic experience had low-risk for recurrence and excellent disease-specific survival at a median follow-up time of 31 months. (c) 2012 Elsevier Inc. All rights reserved.