Comparison of Laparoscopic and Abdominal Radical Hysterectomy for Patients with FIGO Stage Ib1 Cervical Cancer: A Nonrandomized Prospective Analysis

Abstract Background To determine whether additional chemotherapy after concurrent chemoradiation (CCRT) improves survival outcomes in patients with early cervical cancer who undergo radical hysterectomy (RH). Methods We included high- or intermediate-risk patients from two institutions, with 2009 FIGO stage IB–IIA, who underwent primary RH and pelvic lymphadenectomy between January 2007 and June 2020, and had completed adjuvant CCRT. Survival outcomes were compared between patients who received additional chemotherapy (study group) and those who did not (control group). Results A total of 198 patients were included in this analysis. The study (n = 61) and control groups (n = 137) had similar patient age, histologic cancer type, 2009 FIGO stage, and tumor size. However, minimally invasive surgery was performed less frequently in the study group than in the control group (19.7% vs. 46.0%, P < 0.001). The presence of pathologic risk factors was similar, except for lymph node metastasis, which was more frequent in the study group (72.1% vs. 46.0%; P = 0.001). In survival analyses, no differences in the disease-free survival (DFS; P = 0.539) and overall survival (OS; P = 0.121) were observed between the groups. Multivariate analyses adjusting for surgical approach and other factors revealed that additional chemotherapy was not associated with DFS (adjusted HR, 1.149; 95% CI, 0.552–2.391; P = 0.710) and OS (adjusted HR, 1.877; 95% CI, 0.621–5.673; P = 0.264). The recurrence patterns did not differ with additional chemotherapy. Consistent results were observed in a subset of high-risk patients (n = 139). Conclusions Additional chemotherapy after CCRT might not improve survival outcomes in patients with early cervical cancer who undergo RH.

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Preoperative nomogram for prediction of microscopic parametrial infiltration in patients with FIGO stage IB cervical cancer treated with radical hysterectomy

Gynecologic Oncology ◽

10.1016/j.ygyno.2016.05.010 ◽

2016 ◽

Vol 142 (1) ◽

pp. 109-114 ◽

Cited By ~ 13

Author(s):

Tae-Wook Kong ◽

Jayoun Kim ◽

Joo-Hyuk Son ◽

Seong Woo Kang ◽

Jiheum Paek ◽

...

Keyword(s):

Cervical Cancer ◽

Radical Hysterectomy ◽

Figo Stage ◽

Stage Ib

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Comparison of Laparoscopic Versus Abdominal Radical Hysterectomy for FIGO Stage IB and IIA Cervical Cancer With Tumor Diameter of 3 cm or Greater

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000052 ◽

2014 ◽

Vol 24 (2) ◽

pp. 280-288 ◽

Cited By ~ 25

Author(s):

Tae Wook Kong ◽

Suk-Joon Chang ◽

Jisun Lee ◽

Jiheum Paek ◽

Hee-Sug Ryu

Keyword(s):

Cervical Cancer ◽

Radical Hysterectomy ◽

Operating Time ◽

Figo Stage ◽

Tumor Diameter ◽

Pelvic Magnetic Resonance Imaging ◽

Laparoscopic Radical Hysterectomy ◽

Stage Ib ◽

Estimated Blood Loss ◽

The Mean

ObjectiveThere have been many comparative reports on laparoscopic radical hysterectomy (LRH) versus abdominal radical hysterectomy (ARH) for early-stage cervical cancer. However, most of these studies included patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA2 and small (tumor diameter ≤2 or 3 cm) IB1 disease. The purpose of this study was to compare the feasibility, morbidity, and recurrence rate of LRH and ARH for FIGO stage IB and IIA cervical cancer with tumor diameter of 3 cm or greater.Materials and MethodsWe conducted a retrospective analysis of 88 patients with FIGO stage IB and IIA cervical cancer with tumor diameter of 3 cm or greater. All patients had no evidence of parametrial invasion and lymph node metastasis in preoperative gynecologic examination, pelvic magnetic resonance imaging, and positron emission tomography–computed tomography, and they all underwent LRH or ARH between February 2006 and March 2013.ResultsAmong 88 patients, 40 patients received LRH whereas 48 underwent ARH. The mean estimated blood loss was 588.0 mL for the ARH group compared with 449.1 mL for the LRH group (P< 0.001). The mean operating time was similar in both groups (246.0 minutes in the ARH vs 254.5 minutes in the LRH group,P= 0.589). Return of bowel motility was observed earlier after LRH (1.8 vs 2.2 days,P= 0.042). The mean hospital stay was significantly shorter for the LRH group (14.8 vs 18.0 days,P= 0.044). There were no differences in histopathologic characteristics between the 2 groups. The mean tumor diameter was 44.4 mm in the LRH and 45.3 mm in the ARH group. Disease-free survival rates were 97.9% in the ARH and 97.5% in the LRH group (P= 0.818).ConclusionsLaparoscopic radical hysterectomy might be a feasible therapeutic procedure for the management of FIGO stage IB and IIA cervical cancer with tumor diameter of 3 cm or greater. Further randomized studies that could support this approach are necessary to evaluate long-term clinical outcome.

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The Outcome of Laparoscopic Radical Hysterectomy and Lymphadenectomy for Cervical Cancer: A Prospective Analysis of 295 Patients

Annals of Surgical Oncology ◽

10.1245/s10434-008-0063-3 ◽

2008 ◽

Vol 15 (10) ◽

pp. 2847-2855 ◽

Cited By ~ 58

Author(s):

Yong Chen ◽

Huichen Xu ◽

Yuyan Li ◽

Dan Wang ◽

Junnan Li ◽

...

Keyword(s):

Cervical Cancer ◽

Radical Hysterectomy ◽

Prospective Analysis ◽

Laparoscopic Radical Hysterectomy

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Treatment of cervical cancer in the Republic of Srpska

Medicinski pregled ◽

10.2298/mpns1112588l ◽

2011 ◽

Vol 64 (11-12) ◽

pp. 588-591 ◽

Cited By ~ 1

Author(s):

Nenad Lucic ◽

Zora Antonic ◽

Vesna Ecim ◽

Dragica Draganovic ◽

Ljiljana Latinovic

Keyword(s):

Cervical Cancer ◽

Postoperative Complications ◽

Radical Hysterectomy ◽

Invasive Cervical Cancer ◽

Figo Stage ◽

International Federation ◽

Gynecology And Obstetrics ◽

The Republic ◽

Banja Luka ◽

Cervical Tumors

Introduction. Since 1897, when the first radical hysterectomy with lymphadenectomy was done by Wertheim in Vienna, this operation has had the central role in the surgical treatment of invasive cervical tumors. Material and methods. In the period from 1997 to 2010, 177 patients diagnosed with invasive cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) stage IB1 - II were operated at the Department of Obstetrics and Gynecology in Banja Luka. All patients underwent radical hysterectomy by Wertheim - Meigs. The aim of this study is to present the technique of this operation, as well as its effectiveness in the treatment of cervical cancer. Results. The distribution of the patients having invasive cervical cancer according to the International Federation of Gynecology and Obstetrics classification was as follows: I B1 - 35.67%, I B2 - 23.17%, II A - 15.48%, II B - 25.68% on average is 21.3 removed lymph glands. The rate of intraoperative and postoperative complications was 8 (4.51%) and 17 (9.60%), respectively. Of the 26 patients who were operated in the period from 2005 - 2010, 13 had stage II B according to the International Federation of Gynecology and Obstetrics; there were 6 lethal outcomes (23.08) and the five-year survival rate was 76.92%. Discussion and conclusion. By applying the proper surgical technique and early prevention of immediate complications, we achieved satisfactory results in operative morbity and mortality, intraoperative and postoperative complications of the lesion for radical surgery by the Wertheim- Meigs-in the treatment of cancer of the uterus in the I B - II B stage according to the International Federation of Gynecology and Obstetrics classification.

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Selection criteria of non-radical hysterectomy for FIGO stage IB 1 invasive cervical cancer.

10.26226/morressier.5770e29bd462b80290b4b971 ◽

2016 ◽

Author(s):

Takahiro Kasamatsu

Keyword(s):

Cervical Cancer ◽

Radical Hysterectomy ◽

Selection Criteria ◽

Invasive Cervical Cancer ◽

Figo Stage ◽

Stage Ib

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Radical Hysterectomy After Neoadjuvant Chemotherapy for Locally Bulky-Size Cervical Cancer: A Retrospective Comparative Analysis between the Robotic and Abdominal Approaches

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16203833 ◽

2019 ◽

Vol 16 (20) ◽

pp. 3833 ◽

Cited By ~ 1

Author(s):

Chia-Hao Liu ◽

Yu-Chieh Lee ◽

Jeff Chien-Fu Lin ◽

I-San Chan ◽

Na-Rong Lee ◽

...

Keyword(s):

Cervical Cancer ◽

Neoadjuvant Chemotherapy ◽

Radical Hysterectomy ◽

Disease Free Survival ◽

Figo Stage ◽

Lower Percentage ◽

Perioperative Outcomes ◽

Survival Outcomes ◽

Agent Based ◽

Multi Agent

Radical hysterectomy (RH) is the standard treatment for early stage cervical cancer, but the surgical approach for locally bulky-size cervical cancer (LBS-CC) is still unclear. We retrospectively compared the outcomes of women with LBS-CC treated with neoadjuvant chemotherapy (NACT) and subsequent RH between the robotic (R-RH) and abdominal approaches (A-RH). Between 2012 and 2014, 39 women with LBS-CC FIGO (International Federation of Gynecology and Obstetrics) stage IB2–IIB were treated with NACT-R-RH (n = 18) or NACT-A-RH (n = 21). Surgical parameters and prognosis were compared. Patient characteristics were not significantly different between the groups, but the NACT-R-RH group had significantly more patients with FIGO stage IIB disease, received multi-agent-based NACT, and had a lower percentage of deep stromal invasion than the NACT-A-RH group. After NACT-R-RH, surgical parameters were better, but survival outcomes, such as disease-free survival (DFS) and overall survival (OS), were significantly worse. On multivariate analysis, FIGO stage IIB contributed to worse DFS (p = 0.003) and worse OS (p = 0.012) in the NACT-A-RH group. Women with LBS-CC treated with NACT-R-RH have better perioperative outcomes but poorer survival outcomes compared with those treated with NACT-A-RH. Thus, patients with FIGO stage IIB LBS-CC disease might not be suitable for surgery after multi-agent-based NACT.

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