The study of the national registry ROBOCER, led by the Bellvitge University Hospital and IDIBELL, highlights the benefits of robotic surgery. This study is based on data from all cases of cervical cancer operated with the Da Vinci robot in Spain since 2009. The conclusions of the latest analysis are reported in a scientific paper published in February in the journal Cancers.
4 March is International Human Papillomavirus (HPV) Awareness Day. The vast majority of HPV infections do not cause any health issues, but in the bodies of women who cannot fight the viral infection, HPV causes cervical cancer. Specifically, around 2,000 cases are diagnosed each year in Spain, and worldwide this type of cancer is the fourth leading cause of death from malignant tumours in women.
One of the options for the treatment of this early stage gynaecological cancer is radical hysterectomy. To gather evidence, data from 239 robotic radical hysterectomies performed on the peninsula between 2009 and 2018 with the Da Vinci system have been collected in a single national register, maintained by the ROBOCER research group.
Dr Jordi Ponce, head of the Gynaecology Service of the Bellvitge University Hospital (HUB) and head of the innovation line of surgery and robotics of IDIBELL, has led this multicentre group. National tertiary hospital teams that have taken part in it come from Vall d'Hebron Hospital, Hospital Universitario Virgen del Rocío (Seville), Hospital Clínico San Carlos (Madrid) and Hospital Universitario de Basurto (Bilbao).
Scientific evidence based on a decade record
Based on the study of the data recorded by ROBOCER, two scientific articles have been published in the journal Cancers.
The first article, from November 2020, identifies the following factors for recurrence of cervical cancer after surgery, which account for just under 10% of cases: grade 2 and 3 tumours, larger than 20 mm, adenocarcinoma type, among other common features related to diagnostic tests.
In February 2022, the group's second article was published in Cancers and it aimed to identify those factors influencing oncological outcomes, according to different clinical practices, performed at different hospitals.
In conclusion, those hospitals with a higher number of robotic surgeries deliver better oncological outcomes. Similarly, these hospitals also show a higher number of preoperative tests, sentinel lymph node biopsies and greater participation in clinical trials. Specifically, the HUB is the hospital performing the most robotic hysterectomies in Spain, contributing a large number of them to the national register.
At the same time, the oncological and surgical results of robotic radical hysterectomies have also been audited. Precisely, the group has determined that in our environment the use of robotic surgery allows to exceed the demanding quality objectives proposed by the European Society of Gynaecologiacal Oncology (ESGO).
"Robotic surgery has established itself as a standard and a more precise way of operating, compared to other procedures such as laparoscopy and, of course, to the traditional open approach," says Dr Ponce, who adds: "The study of the national ROBOCER register highlights the good results for the management of cervical cancer. Now we hope to be able to draw conclusions from the ROBOEND register of data on robotic surgeries in the last five years for the treatment of endometrial cancer in Spain and Portugal".
The recent acquisition of a third Da Vinci robot for the HUB’s surgical block will make it possible to further increase robotic activity in gynaecology at our centre. In addition, the Gynaecology Department of the Bellvitge University Hospital has been reaccredited by ESGO as a centre of excellence, trainer of the European subspecialty of Gynaecological Oncology in a rigorous programme of fellows with a title recognised throughout Europe.
See the articles published in Cancers: November 2020 and February 2022