Minimally invasive versus open surgery for women with stage 1A1 and stage 1A2 cervical cancer: A retrospective database cohort study

Hayek, Judy; Mowzoon, Mia; Demissie, Saleshi; Palileo, Albert; Serur, Eli; Goldberg, Gary L.; Alagkiozidis, Ioannis

doi:10.1016/j.amsu.2022.103507

Cited by 4 publications

(1 citation statement)

References 21 publications

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“…Along with the LACC trial, several other epidemiological studies, retrospective cohorts, and meta-analyses were published, showing inferior oncological outcomes for women with early-stage cervical cancer treated by minimally invasive surgery, compared to open surgery [11][12][13][14][15][16][17][18][19]. Since the publication of the LACC trial, the number of minimally invasive surgeries has significantly decreased in centers around the world, and if it still used, it is saved mainly for patients with small lesions under 2 cm [20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Cost–Utility Analysis of Open Radical Hysterectomy Compared to Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

Michaan,

Leshno,

Fire

et al. 2023

Cancers

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We aimed to investigate the cost-effectiveness of open surgery, compared to minimally invasive radical hysterectomy for early-stage cervical cancer, using updated survival data. Costs and utilities of each surgical approach were compared using a Markovian decision analysis model. Survival data stratified by surgical approach and surgery costs were received from recently published data. Average costs were discounted at 3%. The value of health benefits for each strategy was calculated using quality-adjusted life years (QALYs). Incremental cost-effectiveness ratio, calculated using the formula (average cost minimal invasive surgery—average cost open surgery)/(average QALY minimal invasive surgery—average QALY open surgery), was used for cost-effectiveness analysis. One-way sensitivity analysis was conducted for all variables. Open radical hysterectomy was found to be cost-saving compared to minimally invasive surgery with an incremental cost-effectiveness ratio of USD −66 and USD −373 for laparoscopic and robotic surgery, respectively. The most influential parameters in the model were surgery costs, followed by the disutility involved with open surgery. Until further data are generated regarding the survival of patients with early-stage cervical cancer treated by minimally invasive surgery, at current pricing, open radical hysterectomy is cost-saving compared to minimally invasive radical hysterectomy, both laparoscopic and robotic.

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Section: Introductionmentioning

confidence: 99%

Cost–Utility Analysis of Open Radical Hysterectomy Compared to Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

Michaan,

Leshno,

Fire

et al. 2023

Cancers

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Incidence and risk factor of blood transfusion after abdominal radical hysterectomy for cervical cancer: a 10-year retrospective study of the US nationwide inpatient sample

Chen,

Zhu,

Wang

et al. 2024

BMC Cancer

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Background With the rising prevalence of abdominal radical hysterectomy, the need for perioperative blood transfusion has emerged as a significant clinical challenge. Independent risk factors for blood transfusion during abdominal radical hysterectomy remains limited, and identifying these factors is needed. Methods A retrospective analysis of data was performed using the Nationwide Inpatient Sample (NIS), focusing on patients who underwent abdominal radical hysterectomy between 2010 and 2019. Patients were categorized into two groups based on whether they received a blood transfusion. The analysis encompassed various demographic factors, including race, sex, and age, as well as length of stay (LOS), total hospitalization charges, hospital characteristics (admission type, insurance type, bed size, teaching status, geographic location, and hospital region), hospital mortality rates, comorbidities, and perioperative complications. Subsequently, both univariate and multivariate logistic regression analyses were employed to ascertain factors associated with abdominal radical hysterectomy patients requiring blood transfusions. Results Blood transfusions occurred in 14.84% of patients between 2010 and 2019, with a downward trend over time. Receiving a transfusion was associated with several negative outcomes, including a longer length of stay, higher total charges, and complications like thrombocytopenia, acute myocardial infarction, pneumonia, and so on. Additionally, patients who received transfusions were more likely to experience postoperative delirium, deep vein thrombosis, and wound infection. Independent risk factors for blood transfusion include Black race, Asian or Pacific Islander race, non-elective surgery, hospitalization in a rural setting, pre-existing medical conditions like coagulopathy, chronic blood loss anemia, deficiency anemia and others. Conversely, patients with private insurance, residing in the West, or Midwest/North Central regions were less likely to require a blood transfusion. Conclusion Our study highlights the concern of perioperative blood transfusion in radical hysterectomy, linked to significant complications. Reducing intraoperative blood loss and optimizing care based on patient factors are crucial for improving outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-024-13216-3.

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Incidence and risk factors for blood transfusion after abdominal radical hysterectomy for cervical cancer: A 10-year retrospective study of the US nationwide inpatient sample

陈,

Zhu,

Wang

et al. 2024

Preprint

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Purpose With the increasing prevalence of abdominal radical hysterectomy, the need for perioperative blood transfusion has emerged as a significant clinical challenge. The independent risk factors for blood transfusion during abdominal radical hysterectomy remain limited, and identifying these factors is needed. Methods The Kolmogorov‒Smirnov test was used to assess the normality of continuous variables. Continuous variables with normal distributions were evaluated using Student’s t test, and noncontinuous variables were evaluated using the Mann‒Whitney U test. Categorical variables were evaluated using the χ2 test. Multivariate logistic regression analyses were implemented to identify potential predictors. Results Blood transfusions occurred in 14.84% of patients between 2010 and 2019, with a decreasing trend over time. Receiving a transfusion was associated with several negative outcomes, including a longer length of stay, higher total charges, and an increased risk of complications such as thrombocytopenia, acute myocardial infarction, and pneumonia. Additionally, patients who received transfusions were more likely to experience postoperative delirium, deep vein thrombosis, and wound infection. Independent risk factors for blood transfusion included age greater than 60 years, black race, Asian or Pacific Islander race, nonelective surgery, hospitalization in a rural setting, and preexisting medical conditions such as coagulopathy, chronic blood loss anemia, and deficiency anemia. Conversely, patients with private insurance residing in the West or Midwest/North Central Regions were less likely to require a blood transfusion. Conclusion Stratifying analyses by race, geographic region, and comorbidity profile among cervical cancer patients is important for enabling the implementation of targeted interventions and improving patient care.

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Minimally invasive versus open surgery for women with stage 1A1 and stage 1A2 cervical cancer: A retrospective database cohort study

Cited by 4 publications

References 21 publications

Cost–Utility Analysis of Open Radical Hysterectomy Compared to Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

Cost–Utility Analysis of Open Radical Hysterectomy Compared to Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

Incidence and risk factor of blood transfusion after abdominal radical hysterectomy for cervical cancer: a 10-year retrospective study of the US nationwide inpatient sample

Incidence and risk factors for blood transfusion after abdominal radical hysterectomy for cervical cancer: A 10-year retrospective study of the US nationwide inpatient sample

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