Laparoscopic pelvic exenteration and laterally extended endopelvic resection for postradiation recurrent cervical carcinoma: Technical feasibility and short-term oncologic outcome

Kanao, Hiroyuki; Aoki, Yoichi; Omi, Makiko; Nomura, Hidetaka; Tanigawa, Terumi; Okamoto, Sanshiro; Chang, Erica J.; Kurita, Tomoko; Netsu, Sachiho; Matoda, Maki; Omatsu, Kohei; Matsuo, Koji

doi:10.1016/j.ygyno.2020.12.034

Cited by 14 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this context, we consider that tumor diameter together with pelvic sidewall involvement should be an important criterion in selecting patients for an open versus a minimally invasive approach. In fact, even though some reports have shown the feasibility of laterally extended pelvic resection by laparoscopy, this approach should be used with caution as achievement of free surgical margins cannot be compromised 13 28…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the minimally invasive group had a shorter length of stay and lower total charge compared with the open surgery group 11. However, the oncological safety of minimally invasive pelvic exenteration has only been analyzed in a few case reports or small case series with limited follow-up and in most cases no comparison with an open approach group 10 12–15…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Minimally invasive versus open pelvic exenteration in gynecological malignancies: a propensity-matched survival analysis

Bizzarri

Chiàntera

Loverro

et al. 2023

Int J Gynecol Cancer

View full text Add to dashboard Cite

ObjectiveThe primary endpoint of this study was to compare the disease-free survival of patients undergoing open versus minimally invasive pelvic exenteration. The secondary endpoints were cancer-specific survival and peri-operative morbidity.MethodsA multi-center, retrospective, observational cohort study was undertaken. Patients undergoing curative and palliative anterior or total pelvic exenteration for gynecological cancer by a minimally invasive approach and an open approach between June 2010 and May 2021 were included. Patients with distant metastases were excluded. A 1:2 propensity match analysis between patients undergoing minimally invasive and open pelvic exenteration was performed to equalized baseline characteristics.ResultsAfter propensity match analysis a total of 117 patients were included, 78 (66.7%) and 39 (33.3%) in the open and minimally invasive group, respectively. No significant difference in intra-operative (23.4% vs 10.3%, p=0.13) and major post-operative complications (24.4% vs 17.9%, p=0.49) was evident between the open and minimally invasive approach. Patients undergoing open pelvic exenteration received higher rates of intra-operative transfusions (41.0% vs 17.9%, p=0.013). Median disease-free survival was 17.0 months for both the open and minimally invasive groups (p=0.63). Median cancer-specific survival was 30.0 months and 26.0 months in the open and minimally invasive groups, respectively (p=0.80). Positivity of surgical margins at final histology was the only significant factor influencing the risk of recurrence (hazard ratio (HR) 2.38, 95% CI 1.31 to 4.31) (p=0.004), while tumor diameter ≥50 mm at the time of pelvic exenteration was the only significant factor influencing the risk of death (HR 1.83, 95% CI 1.08 to 3.11) (p=0.025).ConclusionIn this retrospective study no survival difference was evident when minimally invasive pelvic exenteration was compared with open pelvic exenteration in patients with gynecological cancer. There was no difference in peri-operative complications, but a higher intra-operative transfusion rate was seen in the open group.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimally invasive versus open pelvic exenteration in gynecological malignancies: a propensity-matched survival analysis

Bizzarri

Chiàntera

Loverro

et al. 2023

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

“…Moreover, there were no grade 3/4 complications requiring invasive intervention in our cohort in terms of postoperative complications. A previous study had reported 22–28% of grade 4 complications after LEER [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of laterally extended endopelvic resection for sarcoma in the female genital tract: a prospective cohort study

Park

Kim

et al. 2022

Obstet Gynecol Sci

View full text Add to dashboard Cite

This study aims to evaluate the safety and feasibility of laterally extended endopelvic resection (LEER) for sarcoma in the female genital tract. MethodsWe prospectively recruited gynecologic cancer patients with sarcoma arising from female genital tract who underwent LEER at Seoul National University Hospital from December 2016 to March 2021. Clinicopathologic characteristics, surgical outcomes including postoperative complications and pain control, and survival outcomes of the patients were investigated. ResultsA total of nine patients were registered for this study. The median age was 56 years. Carcinosarcoma (n=2, 22%), leiomyosarcoma (n=2, 22%), and undifferentiated uterine sarcoma (n=2, 22%) were common histology types. Complete resection was achieved in 88.9%. The most common location of pelvic sidewall tumors was infra-iliac acetabulum (66.7%). The pathologic outcome showed a median tumor size of 9.0 cm and internal iliac vessel resection with pelvic sidewall muscle was performed in all patients. The median estimated blood loss was 1,600 mL (range, 300-22,300), and the patients were postoperatively admitted to the intensive care unit (ICU) for median 1 day (range, 0-8). Complete response was observed in 44.4% (4/9) in radiologic studies after LEER, and median progression-free survival, treatment-related survival, and overall survival were 3.3, 19.6, and 98.9 months, respectively. ConclusionLEER was feasible and safe in treating recurrent sarcoma presenting pelvic sidewall invasion with acceptable survival outcomes and manageable postoperative complications.

show abstract

“…Some scholars have used Endu combined with radiotherapy and chemotherapy in the treatment of inoperable patients with cervical cancer without metastasis. In one study, Endu combined with radiotherapy and chemotherapy improved the CR rate and 1-and 3-year OS rates of patients[ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Endu combined with concurrent chemotherapy and radiotherapy for stage IIB-IVA cervical squamous cell carcinoma patients

Zhao¹,

Su²,

Zhang³

et al. 2021

WJCC

View full text Add to dashboard Cite

BACKGROUND In recent years, the incidence of cervical cancer has increased with increasing life pressures and changes in women's social roles, posing a serious threat to women's physical and mental health. AIM To explore the clinical effect of Endo combined with concurrent radiotherapy and chemotherapy in the treatment of advanced cervical squamous cell carcinoma. METHODS A total of 120 patients admitted to the oncology department of our hospital were selected as the research subjects. They were equally divided into the test group and the control group (60 patients each) with a random number table. The test group was treated with Endo combined with concurrent radiotherapy and chemotherapy, and the control group was treated with concurrent radiotherapy and chemotherapy. We compared the serum thymidine kinase 1 (TK1), human epididymis protein 4 (HE4), vascular endothelial growth factor (VEGF), and squamous cell carcinoma-associated antigen (SCC-Ag) levels, the clinical effects and survival before and after radiotherapy and chemotherapy, the quality score, and the 3-year follow-up outcomes between the two groups. RESULTS After chemotherapy, the complete remission + partial remission rate was 85.00% in the test group and 68.33% in the control group; the difference was not statistically significant ( P > 0.05). Before chemotherapy, the serum TK1, HE4, VEGF, and SCC-Ag levels of the two groups were not significantly different ( P > 0.05). After chemotherapy, the levels of serum TK1 (1.27 ± 0.40 pmol/L), HE4 (81.4 ± 24.0 pmol/L), VEGF (235.1 ± 38.0 pg/mL), and SCC-Ag (1.76 ± 0.55 ng/mL) were lower than those in the control group [TK1 (1.58 ± 0.51 pmol/L), HE4 (98.0 ± 28.6) pmol/L, VEGF (284.2 ± 54.1 pg/mL), and SCC-Ag (2.34 ± 0.78 ng/mL)]. The difference was statistically significant ( P < 0.05). Before chemotherapy, there were no significant differences in the physical, role, mood, cognition, social and symptom scale scores of the two groups ( P > 0.05). After chemotherapy, the physical, role, mood, cognitive and social scores were higher in the test group than in the control group, and the difference was statistically significant ( P < 0.05). The symptom scale scores of the test group were all lower than those of the control group, and the difference was statistically significant ( P < 0.05). The 3-year progression-free survival (PFS) rate was 43.33% in the test group and 26.67% in the control group; the overall survival (OS) rate was 48.33% in the test group and 33.33% in the control group; the differences were not statistically significant ( P > 0.05). The 3-year PFS time of the test group was 20.0 mo, which was longer than that of the control group (15.0 mo), and the difference was significant ( P < ...

show abstract

Laparoscopic pelvic exenteration and laterally extended endopelvic resection for postradiation recurrent cervical carcinoma: Technical feasibility and short-term oncologic outcome

Cited by 14 publications

References 27 publications

Minimally invasive versus open pelvic exenteration in gynecological malignancies: a propensity-matched survival analysis

Minimally invasive versus open pelvic exenteration in gynecological malignancies: a propensity-matched survival analysis

Safety and feasibility of laterally extended endopelvic resection for sarcoma in the female genital tract: a prospective cohort study

Endu combined with concurrent chemotherapy and radiotherapy for stage IIB-IVA cervical squamous cell carcinoma patients

Contact Info

Product

Resources

About