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Robotic radical hysterectomy is superior to laparoscopic radical hysterectomy and open radical hysterectomy in the treatment of cervical cancer

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  • Yue-Mei Jin
  • Shan-Shan Liu
  • Jun Chen
  • Yan-Nan Chen
  • Chen-Chen Ren

Abstract

Objective: Cervical cancer (CC) continues to be a global burden for women, with higher incidence and mortality rates reported annually. Many countries have witnessed a dramatic reduction in the prevalence of CC due to widely accessed robotic radical hysterectomy (RRH). This network meta-analysis aims to compare intraoperative and postoperative outcomes in way of RRH, laparoscopic radical hysterectomy (LTH) and open radical hysterectomy (ORH) in the treatment of early-stage CC. Methods: A comprehensive search of PubMed, Cochrane Library and EMBASE databases was performed from inception to June 2016. Clinical controlled trials (CCTs) of above three hysterectomies in the treatment of early-stage CC were included in this study. Direct and indirect evidence were incorporated for calculating values of weighted mean difference (WMD) or odds ratio (OR), and drawing the surface under the cumulative ranking curve (SUCRA). Results: Seventeen 17 CCTs were ultimately enrolled in this network meta-analysis. The network meta-analysis showed that patients treated by RRH and LRH had lower estimated blood loss compared to patients treated by ORH (WMD = -399.52, 95% CI = -600.64~-204.78; WMD = -277.86, 95%CI = -430.84 ~ -126.07, respectively). Patients treated by RRH and LRH had less hospital stay (days) than those by ORH (WMD = -3.49, 95% CI = -5.79~-1.24; WMD = -3.26, 95% CI = -5.04~-1.44, respectively). Compared with ORH, patients treated with RRH had lower postoperative complications (OR = 0.21, 95%CI = 0.08~0.65). Furthermore, the SUCRA value of three radical hysterectomies showed that patients receiving RRH illustrated better conditions on intraoperative blood loss, operation time, the number of resected lymph nodes, length of hospital stay and intraoperative and postoperative complications, while patients receiving ORH demonstrated relatively poorer conditions. Conclusion: The results of this meta-analysis confirmed that early-stage CC patients treated by RRH were superior to patients treated by LRH and ORH in intraoperative blood loss, length of hospital stay and intraoperative and postoperative complications, and RRH might be regarded as a safe and effective therapeutic procedure for the management of CC.

Suggested Citation

  • Yue-Mei Jin & Shan-Shan Liu & Jun Chen & Yan-Nan Chen & Chen-Chen Ren, 2018. "Robotic radical hysterectomy is superior to laparoscopic radical hysterectomy and open radical hysterectomy in the treatment of cervical cancer," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-14, March.
    • Handle: RePEc:plo:pone00:0193033
    DOI: 10.1371/journal.pone.0193033
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    References listed on IDEAS

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    1. Ying Long & De-sheng Yao & Xin-wei Pan & Ting-yu Ou, 2014. "Clinical Efficacy and Safety of Nerve-Sparing Radical Hysterectomy for Cervical Cancer: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-13, April.
    2. Ling-Xiao Chen & Yu-Lin Li & Guang-Zhi Ning & Yan Li & Qiu-Li Wu & Jin-Xiu Guo & Hong-Yu Shi & Xiao-Bo Wang & Yong Zhou & Shi-Qing Feng, 2015. "Comparative Efficacy and Tolerability of Three Treatments in Old People with Osteoporotic Vertebral Compression Fracture: A Network Meta-Analysis and Systematic Review," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-17, April.
    3. Anna Chaimani & Julian P T Higgins & Dimitris Mavridis & Panagiota Spyridonos & Georgia Salanti, 2013. "Graphical Tools for Network Meta-Analysis in STATA," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-12, October.
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    Cited by:

    1. Chia-Hao Liu & Yu-Chieh Lee & Jeff Chien-Fu Lin & I-San Chan & Na-Rong Lee & Wen-Hsun Chang & Wei-Min Liu & Peng-Hui Wang, 2019. "Radical Hysterectomy After Neoadjuvant Chemotherapy for Locally Bulky-Size Cervical Cancer: A Retrospective Comparative Analysis between the Robotic and Abdominal Approaches," IJERPH, MDPI, vol. 16(20), pages 1-19, October.

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