Comparison of oncological outcomes and major complications between laparoscopic radical hysterectomy and abdominal radical hysterectomy for stage IB1 cervical cancer with a tumour size less than 2 cm

2021 ◽  
Author(s):  
Zhiqiang Li ◽  
Chunlin Chen ◽  
Ping Liu ◽  
Hui Duan ◽  
Mubiao Liu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Tumour Size ◽  
Laparoscopic Radical Hysterectomy ◽  
Oncological Outcomes ◽  
Major Complications

scholarly journals Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: a multicenter analysis

2021 ◽  
pp. ijgc-2020-002086
Author(s):  
Juliana Rodriguez ◽  
Jose Alejandro Rauh-Hain ◽  
James Saenz ◽  
David Ortiz Isla ◽  
Gabriel Jaime Rendon Pereira ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Disease Free Survival ◽  
Free Survival ◽  
Laparoscopic Radical Hysterectomy ◽  
Oncological Outcomes ◽  
Early Stage Cervical Cancer ◽  
Laparotomy Group ◽  
Disease Free

IntroductionRecent evidence has shown adverse oncological outcomes when minimally invasive surgery is used in early-stage cervical cancer. The objective of this study was to compare disease-free survival in patients that had undergone radical hysterectomy and pelvic lymphadenectomy, either by laparoscopy or laparotomy.MethodsWe performed a multicenter, retrospective cohort study of patients with cervical cancer stage IA1 with lymph-vascular invasion, IA2, and IB1 (FIGO 2009 classification), between January 1, 2006 to December 31, 2017, at seven cancer centers from six countries. We included squamous, adenocarcinoma, and adenosquamous histologies. We used an inverse probability of treatment weighting based on propensity score to construct a weighted cohort of women, including predictor variables selected a priori with the possibility of confounding the relationship between the surgical approach and survival. We estimated the HR for all-cause mortality after radical hysterectomy with weighted Cox proportional hazard models.ResultsA total of 1379 patients were included in the final analysis, with 681 (49.4%) operated by laparoscopy and 698 (50.6%) by laparotomy. There were no differences regarding the surgical approach in the rates of positive vaginal margins, deep stromal invasion, and lymphovascular space invasion. Median follow-up was 52.1 months (range, 0.8–201.2) in the laparoscopic group and 52.6 months (range, 0.4–166.6) in the laparotomy group. Women who underwent laparoscopic radical hysterectomy had a lower rate of disease-free survival compared with the laparotomy group (4-year rate, 88.7% vs 93.0%; HR for recurrence or death from cervical cancer 1.64; 95% CI 1.09–2.46; P=0.02). In sensitivity analyzes, after adjustment for adjuvant treatment, radical hysterectomy by laparoscopy compared with laparotomy was associated with increased hazards of recurrence or death from cervical cancer (HR 1.7; 95% CI 1.13 to 2.57; P=0.01) and death for any cause (HR 2.14; 95% CI 1.05–4.37; P=0.03).ConclusionIn this retrospective multicenter study, laparoscopy was associated with worse disease-free survival, compared to laparotomy.

scholarly journals The Effect of Laparoscopic Radical Hysterectomy Surgical Volume on Oncology Outcomes in Early-Stage Cervical Cancer

2021 ◽  
Vol 8 ◽  
Author(s):  
Pengfei Li ◽  
Jiaqi Liu ◽  
Li Wang ◽  
Shang Kang ◽  
Ying Yang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Blood Loss ◽  
Radical Hysterectomy ◽  
Multivariable Analysis ◽  
High Volume ◽  
Surgical Volume ◽  
Laparoscopic Radical Hysterectomy ◽  
Oncological Outcomes ◽  
Volume Group ◽  
Low Volume

Purpose: To examine the association between surgical volume and surgical and oncological outcomes of women with stage IB1 cervical cancer who underwent laparoscopic radical hysterectomy (LRH).Methods: We retrospectively analyzed the oncological outcomes of 1,137 patients with stage IB1 cervical cancer receiving LRH from 2004 to 2016. The surgical volume for each surgeon was defined as low [fewer than 50 surgeries, n = 392(34.5%)], mid [51-100 surgeries, n = 315(27.7%)], and high [100 surgeries or more, n = 430(37.8%)]. Surgical volume-specific survival was examined with Kaplan–Meier analysis, multivariable analysis, and propensity score matching.Results: The operative times of the high-volume group (227.35 ± 7.796 min) were significantly shorter than that of the low- (272.77 ± 4.887 min, p < 0.001) and mid-volume (255.86 ± 4.981 min, p < 0.001) groups. Blood loss in the high-volume group (169.42 ± 8.714 ml) was significantly less than that in the low-volume group (219.24 ± 11.299 ml, p = 0.003). The 5-year disease-free survival (DFS) and overall survival (OS) in the low-volume, mid-volume, and high-volume groups were similar (DFS: 91.9, 86.7, and 89.2%, p = 0.102; OS: 96.4, 93.5, and 94.2%, p = 0.192). Multivariable analysis revealed surgical volume was not an independent risk factor for OS or DFS. The rate of intraoperative and postoperative complications was similar among the three groups (p = 0.210).Conclusions: Surgical volume of LRH may not be a prognostic factor for patients with stage IB1 cervical cancer. Surgery at high-volume surgeon is associated with decreased operative time and blood loss.

scholarly journals Impact of Surgeons’ Experience on Oncologic Outcomes in Women Undergoing Laparoscopic Radical Hysterectomy for Cervical Cancer: A Comparison of the First 50 and last 50 Cases

2020 ◽  
Author(s):  
Pengfei Li ◽  
Shan Kang ◽  
Jianxin Guo ◽  
Shiqi Liang ◽  
Ying Yang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Laparoscopic Radical Hysterectomy ◽  
Oncological Outcomes ◽  
Early Stage Cervical Cancer ◽  
Early Cervical Cancer

Abstract Objectives: To compare the oncological outcomes of the first 50 laparoscopic radical hysterectomy (LRH) surgeries with the last 50 LRH, performed by high volume surgeons, for cervical cancer patients.Design: A nationwide multicentre retrospective cohort study Setting: Clinical diagnosis and treatment of cervical cancer patients in mainland China (Four C) database.Population: women with early cervical cancer undergone LRH. Methods: We retrospectively analyzed the oncological outcomes of 1004 cervical cancer patients who underwent LRH performed by 19 surgeons. They were divided into two groups according to the sequence of operations, the first 50 and the last 50 patients with LRH. Kaplan-Meier survival analysis and log-rank test, Cox proportional risk regression model and propensity score matching were used. Main Outcome Measures: 5-year overall survival (OS) and disease-free survival (DFS) rates. Results: There were no significant differences in the 5-year OS and DFS between first 50 patients with LRH group (n=413) and last 50 patients with LRH group (n=591) (OS: p=0.388; DFS: p=0.226). The last 50 cases of LRH was not an independent risk factor for OS and DFS in early cervical cancer patients (p=0.830, p=0.300). After propensity score matching, similar outcomes were observed (n=364:364，OS:P = 0.764; DFS:P = 0.705). Conclusions: The oncological outcomes of the first 50 LRH surgeries were similar to those of the last 50 surgeries in patients with early-stage cervical cancer. Increase in the surgeons’ experience did not improve significantly with oncological outcomes of patients with early stage cervical cancer after LRH.

Laparoscopic radical hysterectomy with lymphadenectomy in patients with early cervical cancer: Our instruments and technique

2009 ◽  
Vol 18 (4) ◽  
pp. 289-297 ◽  
Author(s):  
Mario Malzoni ◽  
Raffaele Tinelli ◽  
Francesco Cosentino ◽  
Ciro Perone ◽  
Domenico Iuzzolino ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Laparoscopic Radical Hysterectomy ◽  
Early Cervical Cancer
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