Long-Term Oncological Outcome After Conventional Radical Hysterectomy Versus 2 Nerve-Sparing Modalities for Early Stage Cervical Cancer

Gent, Mignon D J M van; Rademaker, M.; Veer, Johanna Cornelia Bernadette van der; Poelgeest, Mariëtte Inie Elizabeth van; Gaarenstroom, Katja N.; Putter, Hein; Trimbos, J. B.; Kroon, Cor D. de

doi:10.1097/igc.0000000000001067

Cited by 11 publications

(5 citation statements)

References 25 publications

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“…Moreover, in the recent years minimally invasive surgery has emerged for the treatment of several benign and malignant conditions, including CC [10111213]. Accumulating data from well conducted retrospective and prospective study underlined that minimally invasive surgery upholds long-term outcomes of open abdominal procedures, minimizing postoperative morbidity [1415161718], but mature data on long-term safety of minimally invasive radical hysterectomy are lacking.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive surgery improves short-term outcomes of nerve-sparing radical hysterectomy in patients with cervical cancer: a propensity-matched analysis with open abdominal surgery

et al. 2019

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Objectives Nerve-sparing radical hysterectomy has been implemented in order to reduce pelvic floor dysfunctions in women undergoing radical surgery for cervical cancer. Here, we aimed to investigate if the adoption of laparoscopic surgery impacts on patients' outcomes. Methods Data of consecutive patients affected by cervical cancer who had laparoscopic nerve-sparing radical hysterectomy were matched 1:1 with an historical cohort of patients undergoing open procedure. A propensity-score matched algorithm was applied. Results Thirty-five patients' pairs (70 patients: 35 undergoing laparoscopic vs. 35 undergoing open abdominal nerve-sparing radical hysterectomy) were included. Demographic and baseline oncologic characteristics were balanced between groups. Patients undergoing laparoscopic surgery had similar operative time than patients undergoing open abdominal procedures (249 [±91.5] vs. 223 [±65.0] minutes; p=0.066). Laparoscopic approach correlated with lower blood loss (30.5 [±11.0] vs. 190 [90.4] mL; p<0.001) and shorter hospital stay (3.2 [±1.2] vs. 5.4 [2.0] days; p=0.023). Patients undergoing laparoscopy experienced a lower 30-day pelvic floor dysfunction rate than patients having open surgery. Moreover, they experienced shorter recovery of bladder function than patients having open procedures (median, 7 vs. 9 days; p=0.004, log-rank test). Conclusion Laparoscopic approach resulted in a faster recovery of bladder function in comparison to open surgery for patients undergoing nerve-sparing radical hysterectomy.

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Section: Introductionmentioning

confidence: 99%

Minimally invasive surgery improves short-term outcomes of nerve-sparing radical hysterectomy in patients with cervical cancer: a propensity-matched analysis with open abdominal surgery

et al. 2019

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“…van Gent et al reported similar survival outcomes between nerve-sparing RH and conventional RH. 22 Q-M type C1 RH is a highly precise surgery that lack popularity in China. Additionally, full evaluation data related to postoperative bladder, anorectal, and sexual dysfunction is not available in the Four C database.…”

Section: Discussionmentioning

confidence: 99%

<p>Survival After Abdominal Q-M Type B versus C2 Radical Hysterectomy for Early-Stage Cervical Cancer</p>

Chen¹,

Wang²,

Liu³

et al. 2019

CMAR

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These authors contributed equally to this workPurpose: To evaluate the survival outcomes of abdominal Q-M type B and type C2 radical hysterectomy (RH) for early-stage (IA1 (lymphovascular invasion)-IIA2) cervical cancer. Patients and methods: Based on this multicenter, retrospective cohort study on the clinical diagnosis and treatment for cervical cancer in China (Four C), the survival outcomes of abdominal type B and type C2 RH for early-stage cervical cancer were compared under real-world and matched cohort study conditions. Results: In total, 46,313 cases were included in the Four C database, among whom 20,018 underwent abdominal type B or type C2 RH. In the real-world study, no differences were found in the 5-year overall survival (OS) between the type B group (n=15,471) and type C2 group (n=4547), but the 5-year disease-free survival (DFS) was lower in the type C2 group (82.1 vs 84.8%, hazard ratio: 1.144). Based on the inclusion criteria, 9135 cases were included and the type C2 group (n=1818) was found to have a lower 5-year OS and DFS (OS: 89.5 vs 92.0%, hazard ratio: 1.393; DFS: 84.3 vs 87.4%, hazard ratio: 1.342). Subsequently, 1799 cases from each group were matched and the type C2 group had a lower 5-year DFS (84.6 vs 88.4%, hazard ratio: 1.332). Upon further analysis of the subgroups, the type C2 group had a lower 5-year OS and DFS (OS: 90.3 vs 93.8%, hazard ratio: 1.522; DFS: 85.2 vs 89.4%, hazard ratio: 1.439). Conclusion: Q-M type B RH could be used for the treatment of stage IA1 (lymphovascular invasion)-IIA2 cervical cancer.

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“…Although the Querleu-Morrow classification8,9 provides a reproducible anatomic terminology for NSRH, it was not designed to impose a universal surgical technique. The description of surgical procedures and energy instruments for NSRH and TRH differ considerably among different studies,17,18 suggesting that different surgeons are performing operations without standardized techniques and processes, even though the autonomic nerves form well-defined anatomic boundaries for NSRH. The success determining factors of nerve-sparing, such as FIGO stage or pathologic subtype, were little known 5,19,20.…”

Section: Discussionmentioning

confidence: 99%

Surgical, Urinary, and Survival Outcomes of Nerve-sparing Versus Traditional Radical Hysterectomy

Tan

et al. 2019

American Journal of Clinical Oncology

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Long-Term Oncological Outcome After Conventional Radical Hysterectomy Versus 2 Nerve-Sparing Modalities for Early Stage Cervical Cancer

Abstract: The nerve-sparing radical hysterectomy shows a similar oncological outcome compared with the CRH. The more radical Swift version of nerve-sparing techniques is preferable to the former LNSRH procedure.

Cited by 11 publications

References 25 publications

Minimally invasive surgery improves short-term outcomes of nerve-sparing radical hysterectomy in patients with cervical cancer: a propensity-matched analysis with open abdominal surgery

Minimally invasive surgery improves short-term outcomes of nerve-sparing radical hysterectomy in patients with cervical cancer: a propensity-matched analysis with open abdominal surgery

<p>Survival After Abdominal Q-M Type B versus C2 Radical Hysterectomy for Early-Stage Cervical Cancer</p>

Surgical, Urinary, and Survival Outcomes of Nerve-sparing Versus Traditional Radical Hysterectomy

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