Rationale for the avoidance of parametrectomy and systematic lymphadenectomy in patients with early stages of neuroendocrine cervical cancer

Cibula, David

doi:10.1136/ijgc-2021-002510

Cited by 1 publication

(1 citation statement)

References 7 publications

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“…It has been hypothesized that a simple hysterectomy may be adequate when followed by adjuvant radiotherapy with concurrent cisplatin and etoposide followed by additional chemotherapy, even in neuroendocrine cervical carcinoma [ 29 ]. In addition, Anderson et al suggested altering the current recommendations for the surgical management of early-stage neuroendocrine carcinoma [ 29 30 ]. Furthermore, considering data from the ConCerv and SHAPE trials [ 6 31 ], reduced parametrial resection for cervical cancer <2 cm can be considered.…”

Section: Discussionmentioning

confidence: 99%

Improved bladder function in radical hysterectomy without worsening oncologic outcome: resection of the posterior layer of the vesicouterine ligament with the procedure limited to the vesical veins

Chikazawa,

Imai,

Kuwata

et al. 2024

J Gynecol Oncol

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Objective The classic Okabayashi nerve-sparing radical hysterectomy involves complete resection of the posterior leaf of the vesicouterine ligament, whereas in the simplified nerve-sparing radical hysterectomy, only the vesical veins and some connective tissue of the posterior layer of the vesicouterine ligament are resected. This study aimed to compare bladder function and cervical carcinoma relapse-free survival between these two techniques. Methods We conducted a retrospective, historical control study. All female patients aged >20 years who were diagnosed with cervical cancer stage IB1–IIB and underwent radical hysterectomy with pelvic lymphadenectomy between 2009 and 2022 were enrolled. Patients who had a history of other cancers and those who were treated with non-surgical approaches or non-radical hysterectomy were excluded. The primary outcome was relapse-free survival during the follow-up period. Results A total of 114 patients who underwent curative-intent radical hysterectomy were included in this study. The median follow-up duration was 60 months. No significant difference was observed in relapse-free survival between the two surgical procedures. The simplified nerve-sparing radical hysterectomy was superior in terms of both motor and sensory bladder function outcomes. Conclusion Resection of the posterior layer of the vesicouterine ligament, with the procedure limited to the vesical veins, is an effective and safe method for radical hysterectomy. It may be more useful for preserving the bladder function, without leading to unfavorable oncologic outcomes.

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