The impact of close surgical margins after radical hysterectomy for early-stage cervical cancer

The aim of this study was to evaluate the impact of institutional surgical experience on recurrence following robotic radical hysterectomy (RRH) for early stage cervical cancer. All women in Sweden who underwent an RRH for stage IA2-IB1 cervical cancer at tertiary referral centers from its implementation in December 2005 until June 2017 were identified using a Swedish nationwide register and local hospital registers. Registry data were controlled by a chart review of all women. Recurrence rates and patterns of recurrence were compared between early and late (≤50 vs. >50 procedures) institutional series. Six hundred and thirty-five women were included. Regression analysis identified a lower risk of recurrence with increased experience but without a clear cut off level. Among the 489 women who did not receive adjuvant radio chemotherapy (RC-T), the rate of recurrence was 3.6% in the experienced cohort (>50 procedures) compared to 9.3% in the introductory cohort (p < 0.05). This was also seen in tumors < 2 cm regardless of RC-T (p < 0.05), whereas no difference in recurrence was seen when analyzing all women receiving RC-T. In conclusion, the rate of recurrence following RRH for early stage cervical cancer decreased with increased institutional surgical experience, in tumors < 2 cm and in women who did not receive adjuvant RC-T.

Download Full-text

The impact of intraoperative autologous blood transfusion during type III radical hysterectomy for early-stage cervical cancer

American Journal of Obstetrics and Gynecology ◽

10.1016/s0002-9378(99)70369-8 ◽

1999 ◽

Vol 181 (6) ◽

pp. 1310-1316 ◽

Cited By ~ 40

Author(s):

Ramin Mirhashemi ◽

Hervy E. Averette ◽

Krishnaprasad Deepika ◽

Ricardo Estape ◽

Roberto Angioli ◽

...

Keyword(s):

Cervical Cancer ◽

Blood Transfusion ◽

Radical Hysterectomy ◽

Early Stage ◽

Autologous Blood ◽

Autologous Blood Transfusion ◽

Type Iii ◽

Early Stage Cervical Cancer ◽

The Impact

Download Full-text

Identification Of Risk Factors In Patients With Positive Lymph Node After Radical Hysterectomy For Early Stage Cervical Cancer

10.26226/morressier.59f838b6a874c6001b34ea23 ◽

2017 ◽

Author(s):

Soyi Lim

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Lymph Node ◽

Radical Hysterectomy ◽

Early Stage ◽

Positive Lymph Node ◽

Early Stage Cervical Cancer

Download Full-text

258 Design and validation of a recurrence risk predicting score in early stage cervical cancer after radical hysterectomy

10.1136/ijgc-2020-esgo.17 ◽

2020 ◽

Author(s):

Nabil Manzour ◽

Enrique Chacon ◽

Nerea Martín-Calvo ◽

José Ángel Mínguez ◽

Teresa Castellano ◽

...

Keyword(s):

Cervical Cancer ◽

Radical Hysterectomy ◽

Early Stage ◽

Recurrence Risk ◽

Early Stage Cervical Cancer

Download Full-text

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

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-002086 ◽

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.

Download Full-text

Efficacy of different surgical approaches on survival outcomes in patients with early-stage cervical cancer: protocol for a multicentre longitudinal study in China

BMJ Open ◽

10.1136/bmjopen-2020-038020 ◽

2020 ◽

Vol 10 (8) ◽

pp. e038020

Author(s):

Xiaopei Chao ◽

Ming Wu ◽

Shuiqing Ma ◽

Xianjie Tan ◽

Sen Zhong ◽

...

Keyword(s):

Cervical Cancer ◽

Radical Hysterectomy ◽

Early Stage ◽

Disease Free Survival ◽

Learning Curves ◽

Surgical Approaches ◽

Survival Outcomes ◽

Link Type ◽

Gynecology And Obstetrics ◽

Early Stage Cervical Cancer

IntroductionRecent studies have revealed that the oncological survival outcomes of minimally invasive radical hysterectomy (MIRH) are inferior to those of abdominal radical hysterectomy (ARH) in early-stage cervical cancer, but the potential reasons are unclear.Methods and analysisEach expert from 28 study centres participating in a previously reported randomised controlled trial (NCT03739944) will provide successive eligible records of at least 100 patients who accepted radical hysterectomy for early-stage cervical cancer between 1 January 2009 and 31 December 2015. Inclusion criteria consist of a definite pathological evaluation of stages IA1 (with positive lymphovascular space invasion), IA2 and IB1 according to the International Federation of Gynecology and Obstetrics 2009 staging system and a histological subtype of squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma. The primary endpoint is 5-year disease-free survival between the MIRH and ARH groups. The secondary endpoints include the MIRH learning curves of participating surgeons, 5-year overall survival between the MIRH and ARH groups, survival outcomes according to surgical chronology, surgical outcomes and sites of recurrence and potential risk factors that affect survival outcomes. A subgroup analysis in patients with tumour diameter less than 2 cm will follow the similar flow diagram.Ethics and disseminationThis study has been approved by the Institutional Review Board of Peking Union Medical College Hospital (registration no. JS-1711), and is also filed on record by all other 27 centres. The results will be disseminated through community events and peer-reviewed journals.Trial registration numberNCT03738969

Download Full-text

Sexual dysfunction in Thai women with early-stage cervical cancer after radical hysterectomy

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2007.00907.x ◽

2007 ◽

Vol 17 (5) ◽

pp. 1104-1112 ◽

Cited By ~ 32

Author(s):

S. Tangjitgamol ◽

S. Manusirivithaya ◽

J. Hanprasertpong ◽

P. Kasemsarn ◽

T. Soonthornthum ◽

...

Keyword(s):

Cervical Cancer ◽

Sexual Dysfunction ◽

Sexual Function ◽

Sexual Intercourse ◽

Health Care Providers ◽

Radical Hysterectomy ◽

Early Stage ◽

Care Providers ◽

Public Media ◽

Early Stage Cervical Cancer

We determined the prevalence of sexual dysfunction in women with early-stage cervical cancer who had undergone radical hysterectomy in three institutions of Thailand. An interview was conducted according to the structured questionnaire composing of seven domains of sexual function: frequency, desire, arousal, lubrication, orgasm, satisfaction, and dyspareunia. From 105 women included in the study, mean age was 45.3 ± 7.8 years. Seventy-five (71.4%) were in premenopausal period. Eight out of 105 women (7.6%) never resumed their sexual intercourse after radical hysterectomy, 97 women resumed their sexual intercourse during 1–36 months postoperation (median, 4 months). Dyspareunia was increased in approximately 37% of women, while the other six domains of sexual function were decreased, ranging from approximately 40–60%. Of interest, only 10.5% of these cervical cancer women had some information of sexual function from medical or paramedical personnel, 17.1% obtained it from other laymen or public media, and 61.9% had never had it from any resources. Our conclusion is—sexual dysfunction is a common problem after cervical cancer treatment, but it has not been well aware of. These findings may necessitate health care providers to be more considerate on this problem.

Download Full-text