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Salvage robotic anterior pelvic exenteration for cervical cancer: technique and feasibility

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Abstract

The aim of our study was to explain the technique and evaluate the feasibility and safety of robotic anterior pelvic exenteration in cases of residual/recurrent cervical cancer as a salvage therapy. The study was conducted as a retrospective review of all the cases of central residual/recurrent cervical cancer who underwent anterior pelvic exenteration by robotic approach with curative intent at our centre between January 2013 and December 2019. Information regarding various treatment related parameters like duration of surgery, estimated blood loss, length of hospital stay, early and late complications and recurrence and survival was collected and evaluated. 14 patients underwent anterior pelvic exenteration by robotic approach in this period. The median age of patients at time of exenteration was 52.5 years. 13 out of 14 patients had received combined chemoradiation as a part of intial treatment. The median duration of surgery was 305 min with a median estimated blood loss of 135 ml and median length of hospital stay of 6.5 days. Early complications like urosepsis, uretero-ileal anastomotic leak and paralytic ileus occurred in 36% patients and late complications like ureteric stricture and bowel perforation occurred in 28.6% patients. Negative surgical margins could be achieved in all the patients. Over a median follow-up period of 17.5 months, five patients developed recurrence and five patients experienced mortality, with four out of five patients dying due to recurrent disease. The 12-month DFS was 68.2% and the 12-month OS was 77.1%. Robotic anterior pelvic exenteration is a safe and feasible option in selected patients with recurrent/residual cervical cancer as a salvage procedure, with acceptable morbidity and mortality.

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Authors and Affiliations

  1. Department of Uro-Gynae Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Sector-V, Rohini, Delhi, 110085, India

    Vandana Jain, Subrata Debnath & Sudhir Rawal

Authors
  1. Vandana Jain
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  2. Subrata Debnath
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  3. Sudhir Rawal
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Contributions

Study concept and design-SR; data collection and analysis-VJ, SD; manuscript preparation-VJ; manuscript edition and review-SR; final approval-VJ, SR, SD.

Corresponding author

Correspondence to Vandana Jain.

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The authors declare that they have no conflicts of interest and nothing to disclose.

Ethical approval

Institutional ethical committee and Review board approved the study and requirement of written consent was waived off by IRB. IRB No: RGCIRC/IRB/258.1/2019.

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Jain, V., Debnath, S. & Rawal, S. Salvage robotic anterior pelvic exenteration for cervical cancer: technique and feasibility. J Robotic Surg 15, 945–953 (2021). https://doi.org/10.1007/s11701-021-01195-7

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  • DOI: https://doi.org/10.1007/s11701-021-01195-7

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