Efficacy of Channa Striata Extract Capsule (Vipalbumin®) for Serum Albumin Level and Wound Healing Postradical Hysterectomy in Cervical Cancer Patients

Abstract Objective: To determine the efficacy of Channa striata extract on serum albumin level and wound healing after radical hysterectomy in cervical cancer patients in Mohammad Hoesin Hospital Palembang.Methods: A clinical trial was conducted in Mohammad Hoesin Hospital Palembang during period of January – September 2019. Samples were cervical cancer patients undergoing radical hysterectomy. Serum albumin level was measured before surgery, after surgery, and after the administration of Channa striata extract capsule. Efficacy of the supplement was analyzed with SPSS version 20 using paired t-test.Result: Twenty-eight cervical cancer patients undergoing radical hysterectomy who fulfilled inclusion criteria were obtained. Majority of patients were aged between 40-49 years old (89.3%), normoweight (39.3%), and lived in rural area. Mean duration of surgery was 154.46 ± 40.47 minutes. Serum albumin level before surgery, after surgery and after the administration of Channa striatus extract were 3.4 ± 0.61 g/dL, 2.91 ± 0.42 g/dL, and 3.11 ± 0.49 g/dL, respectively. There was a statistically significant difference between serum albumin level before and after the surgery (p=0.000). However, no statistically significant difference was found between serum albumin level after surgery and after administration of Channa striata extract capsule (p=0.750).Conclusions: There was no significant difference between serum albumin level after surgery and after administration of Channa striata extract capsule.Keywords: cervical cancer , channa striatus extract , radical hysterectomy, serum albumin level. Abstrak Tujuan: Untuk mengetahui efikasi ekstrak Channa striata terhadap kadar albumin serum dan penyembuhan luka pasca histerektomi radikal pada pasien kanker serviks di RS Mohammad Hoesin Palembang.Metode: Uji klinis dilakukan di RS Mohammad Hoesin Palembang selama periode Januari – September 2019. Sampel adalah pasien kanker serviks yang menjalani histerektomi radikal. Kadar albumin serum diukur sebelum operasi, setelah operasi, dan setelah pemberian kapsul ekstrak Channa striata. Khasiat suplemen dianalisis dengan SPSS versi 20 menggunakan uji-t berpasangan.Hasil: Didapatkan 28 pasien kanker serviks yang menjalani histerektomi radikal yang memenuhi kriteria inklusi. Mayoritas pasien berusia antara 40-49 tahun (89,3%), normoweight (39,3%), dan tinggal di daerah pedesaan. Durasi rata-rata operasi adalah 154,46 ± 40,47 menit. Kadar albumin serum sebelum operasi, setelah operasi dan setelah pemberian ekstrak Channa striatus berturut-turut adalah 3,4 ± 0,61 g/dL, 2,91 ± 0,42 g/dL, dan 3,11 ± 0,49 g/dL. Ada perbedaan yang signifikan secara statistik antara kadar albumin serum sebelum dan sesudah operasi (p=0,000). Namun, tidak ditemukan perbedaan yang signifikan secara statistik antara kadar albumin serum setelah operasi dan setelah pemberian kapsul ekstrak Channa striata (p=0,750).Kesimpulan: Tidak terdapat perbedaan yang bermakna antara kadar albumin serum setelah pembedahan dan setelah pemberian kapsul ekstrak Channa striata.Kata kunci: ekstrak Channa striatus, histerektomi radikal, kadar albumin serum, kanker serviks.

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A low albumin to globulin ratio with a high serum globulin level is a prognostic marker for poor survival in cervical cancer patients treated with radiation based therapy

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2018-000025 ◽

2019 ◽

Vol 29 (1) ◽

pp. 17-22 ◽

Cited By ~ 3

Author(s):

Yasunori Yoshino ◽

Ayumi Taguchi ◽

Takuya Shimizuguchi ◽

Yujiro Nakajima ◽

Maki Takao ◽

...

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Serum Albumin ◽

Cancer Patients ◽

Serum Albumin Level ◽

Albumin Level ◽

High Serum ◽

Serum Globulin ◽

Globulin Level ◽

Albumin To Globulin Ratio

ObjectiveWe investigated whether the pretreatment albumin to globulin ratio, serum albumin level, and serum globulin level can be used to predict survival among cervical cancer patients treated with radiation based therapy and assessed globulin fractions.MethodsWe retrospectively enrolled 128 patients with cervical cancer treated with radiation based therapy at our institution between 2010 and 2015. The associations of the pretreatment albumin to globulin ratio, and serum albumin and globulin levels with overall survival were assessed. Additionally, the associations of the globulin fractions with the serum globulin levels and overall survival were evaluated.ResultsMedian follow-up duration was 30 months (IQR 16–44 months). A low albumin to globulin ratio (< 1.53) was found to be an independent prognostic factor for overall survival (HR= 3.07; 95% CI, 1.03 to 13.3; P=0.044). On evaluating serum globulin and albumin separately, a high serum globulin level was significantly associated with overall survival (cut-off value 2.9 g/dL; HR=3.74; 95% CI 1.08 to 23.6; P=0.036) whereas a low serum albumin level was not associated with overall survival (cut-off value 3.6 g/dL; HR=1.77; 95% CI 0.57 to 4.54; P=0.29). Electrophoresis data of the serum proteins revealed that the γ-globulin fraction was most strongly correlated with the globulin levels (P<0.001). Furthermore, a high γ-globulin level (≥1.28 g/dL) was significantly associated with poor overall survival (log rank test, P=0.034).ConclusionsA pretreatment low albumin to globulin ratio, which might be attributable to a high serum globulin level, can be used to predict poor prognosis in cervical cancer patients treated with radiation based therapy.

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Nutritional Status of the Children with Acute Lymphoblastic Leukemia at Diagnosis and after Completion of Induction

Haematology Journal of Bangladesh ◽

10.37545/haematoljbd202174 ◽

2021 ◽

Vol 5 (02) ◽

pp. 50-56

Author(s):

Noor-A-Sabah Liza ◽

S. M. Rezanur Rahman ◽

Afiqul Islam ◽

Chowdhury Yakub Jamal ◽

Mohosina Sultana Setu ◽

...

Keyword(s):

Nutritional Status ◽

Serum Albumin ◽

Induction Chemotherapy ◽

Induction Therapy ◽

Serum Albumin Level ◽

Albumin Level ◽

Anthropometric Measurements ◽

Newly Diagnosed ◽

Significant Difference ◽

Nutritional Status Of Children

Background: Adequate nutrition is an important concern in children with leukemia. Malnutrition and weight lost are common and are due to verity of mechanism involving the tumor, the host response to the tumor such as infection and pharmacokinetics of chemotherapeutic drugs. Objective: To evaluate and compare the nutritional status of children with ALL at diagnosis and after completion of induction therapy. Methodology: This prospective observational study included 60 children newly diagnosed as ALL, aged 2-15 years, over a period from April 2012 to September 2012 in the Department of Pediatric Hematology and Oncology, BSMMU. The anthropometric measurements and serum albumin level were taken. Anthropometric indices are calculated by NCHS (WHO-2000) and classified as Z score. Children <-2 SD are considered as underweight (WFA), stunted (HFA) and wasted (WFH). Serum albumin level below 21g/dl is considered as severely malnourished. The Hb values of the children are compared with normal values by age. The children got induction chemotherapy according to MRC-11 protocol. They were in regular follow up and again anthropometric measurements and serum albumin level were taken after completion of induction. Results: Out of 60 children with ALL, 48 (70%) were underweight, 45 (75%) were stunted 36 (60%) were wasted at diagnosis. Incidence of malnutrition among leukemia children after completion of induction were 24 (40%) underweight, 45 (75%) were stunted and 6 (10%) were wasted. The results showed that children in the newly diagnosed stage had a higher prevalence of malnutrition. However no statistically significant difference in the nutritional status was found among newly diagnosed and after completion of induction in term of underweight and stunting but newly diagnosed patients had statistically significant wasting than patients who had completed induction chemotherapy. No patient showed severe malnutrition based on the cut-off point for serum albumin on both stages. All the children (100%) had less than normal range hemoglobin levels. Conclusion: Malnutrition was higher in children with newly diagnosed leukemia. Children had significant differences in the nutritional status in term of wasting at diagnosis than after completion of induction therapy. So, the nutritional status of children with leukemia should be monitor periodically.

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Serum Albumin Level as a Prognostic Marker for Covid-19 Positive Patients in Western Uttar Pradesh - A Cross Sectional Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/39 ◽

2021 ◽

Vol 8 (04) ◽

pp. 204-207

Author(s):

Shreyansh Talera ◽

Saurabh Singhal ◽

Nishant Wadhera ◽

Mayank Arora ◽

Ravi Pratap

Keyword(s):

Serum Albumin ◽

Prognostic Marker ◽

Serum Albumin Level ◽

Uttar Pradesh ◽

Cross Sectional Study ◽

Albumin Level ◽

The Body ◽

Cross Sectional ◽

Significant Difference

BACKGROUND WHO has declared Coronavirus disease 2019 (Covid-19) as a pandemic. Covid-19 leads to sickness and death. Human serum albumin (HSA) is the most common circulating protein in the body having oncotic as well as non-oncotic properties. The role of albumin in death among Covid-19 subjects, especially in this part of the country has not been frequently reported. The aim of the study was to analyse the role of serum albumin level as prognostic marker for Covid-19 positive patients. METHODS The present study was conducted in the department of Medicine at Chhatrapati Shivaji Subharti Hospital, Subharti Medical College, Meerut, UP. The study comprised of 100 subjects who were Covid positive from May 2020 to July 2020. A detailed explanation was given to all the participating respondents regarding the study and their contribution to it. Covid-19 was diagnosed on the basis of the WHO interim guidelines. A questionnaire was prepared to collect the patients’ demographic profile. Patients date of admission and discharge was recorded along with the outcome i.e., whether patient expired or survived. Patients’ diagnosis was identified along with the comorbidity (if present). Laboratory investigations comprised of CBC and serum albumin detection. Data so collected was tabulated in an excel sheet, under the guidance of statistician. Collected data was analysed using Statistical Package for the Social Sciences (SPSS) software version 24 and the tests used were t test and Fisher’s exact test and the level of significance was set at p < 0.05. RESULTS The study comprised of 100 subjects, out of which 45 were males and 55 were females. The overall mean age of the study subjects was 37.52 years. In our study, mortality was 35.29 %, 9.33 % and 85.7 % of the subjects having Covid-19+ type 2 diabetes (T2DM), only Covid-19 and Covid-19+ hypertension respectively with statistically significant difference as p < 0.05. Albumin level was significantly lower in expired patients (2.99) as compared to survivors (3.85) as p < 0.05. Hospital stay was also higher in expired patients. CONCLUSIONS Covid-19 patients had low serum albumin levels and that might play a role in the survival of patient. KEYWORDS Covid-19, Mortality, Albumin

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The Prevalence of Malnutrition in Patients Suffering from Different Cancers by Three Classification Methods (P05-041-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz030.p05-041-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Wenzhi Zhao ◽

Han Ping Shi

Keyword(s):

Lung Cancer ◽

Head And Neck Cancer ◽

Serum Albumin ◽

Cancer Patients ◽

Gastrointestinal Cancer ◽

Serum Albumin Level ◽

Hematological Malignancy ◽

Albumin Level ◽

Baseline Survey ◽

Classification Methods

Abstract Objectives The objective of this study was to determine the prevalence of malnutrition in hospitalized cancer patients. Methods A facility-based follow-up study was conducted in 84 hospitals across 25 provinces and municipalities from January 2011 to December 2018, during which the number of the involved hospital accumulated slowly. In this study the data of the baseline survey is extracted. The prevalence of malnutrition in hospitalized cancer patients is determined by three classification methods: body mass index (BMI, BMI < 18.5 kg/m2), serum albumin level (serum albumin <35 g/L) and Patient-Generated Subjective Global Assessment (PG-SGA, nutritional assessment of B or C level). Results 36,635 hospitalized patients with different kinds of cancer finished the baseline survey, of whom 54.6% were male and the mean age was 56.6 years old (ranging from 1 to 118.5 years old). On the whole, the prevalence of malnourished nutritional status determined by BMI, serum albumin level and PG-SGA was 12.0%, 20.6% and 80.0%, respectively. The consistent trend is that the prevalence is higher in the male and the old, patients of later-stage, patients with longer duration and patients with metastasis based on three different classification methods. When the cancers were classified into 6 categories, that is lung cancer, head and neck cancer, gastrointestinal cancer, hematological malignancy, urogenital neoplasm and other tumors, the prevalence was highest in gastrointestinal cancer patients, and the prevalence was 16.4%, 26.1% and 87.6% assessed by three methods. While the prevalence in lung cancer patients was 9.3%, 20.7% and 79.4%, in urogenital neoplasm patients was 6.5%, 11.7% and 70.2%, in hematological malignancy patients was 9.2%, 24.6% and 79.1%, in hematological malignancy patients was 9.2%, 24.6% and 79.1% and in patients of head and neck cancer was 11.0%, 9.3% and 62.3%. Conclusions The data showed the high prevalence of malnutrition in hospitalized cancer patients in China in this study. The prevalence of malnutrition in different cancers differed a lot and was highest in gastrointestinal cancer patients. Funding Sources The National Key Research and Development Program of China.

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Comparison of Outcomes After Allogeneic Hematopoietic Cell Transplantation (Allo-HCT) In 73 Patients with Follicular Lymphoma (FL), Transformed Follicular Lymphoma (TL), or De Novo Diffuse Large B-Cell Lymphoma (DLBCL): Favorable Outcome for TL Similar to FL

Blood ◽

10.1182/blood.v116.21.3508.3508 ◽

2010 ◽

Vol 116 (21) ◽

pp. 3508-3508

Author(s):

Kohei Tada ◽

Sung-Won Kim ◽

Yoshitaka Asakura ◽

Nobuhiro Hiramoto ◽

Kimikazu Yakushijin ◽

...

Keyword(s):

Bone Marrow ◽

Serum Albumin ◽

Follicular Lymphoma ◽

B Cell ◽

Serum Albumin Level ◽

B Cell Lymphoma ◽

Albumin Level ◽

High Dose ◽

Intermediate Risk ◽

Significant Difference

Abstract Abstract 3508 Background: Allo-HCT is a therapeutic option for patients (pts) with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL). However, the outcome of allo-HCT with a reduced-intensity conditioning (RIC) regimen for TL remains controversial, and no previous reports have compared the outcomes after allo-HCT for FL, TL, and DLBCL in the rituximab era. Patients and Methods: We retrospectively analyzed 73 consecutive pts with FL (n=33), TL (n=18), or DLBCL (n=22) who received allo-HCT at our institute between January 2000 and December 2008. We defined TL as DLBCL that was histologically proven in pts with pre- (n=8) or co- (n=10) existing FL. The median age of the 73 pts was 47 years (range, 26–67). The median duration from diagnosis to HCT was 38 months (range, 6–175). The median number of prior chemotherapy regimens was 4 (range, 1–10): 57 pts (78%) had received prior rituximab, and 23 (32%) had received high-dose chemotherapy with autologous HCT prior to allo-HCT. The disease status at allo-HCT was CR or PR/refractory; 23 (32%)/50 (68%) for all pts, 10/23 for FL, 7/11 for TL, and 6/16 for DLBCL. The age-adjusted international prognostic index (aaIPI) at HCT was high or high-intermediate risk in 21 pts (28%), and FLIPI at HCT was high risk in 11 pts with FL (15%). The median level of serum albumin at HCT was 4.2 g/dL (range, 2.7–5.1). A myeloablative conditioning regimen was used for 14 pts (19%), and a RIC regimen was used for 59 pts (81%). The donor and stem cell source were related peripheral blood stem cells in 44 pts (60%), related bone marrow in 2 (3%), unrelated bone marrow in 21 (29%), and cord blood in 6 (8 %). Results: With a median follow-up of 68 months in surviving pts, the 5-year estimated overall survival (OS; Figure) and progression-free survival (PFS) were 58% and 54% for all pts, 80% and 71% for FL, 67% and 67% for TL, and 20% and 17% for DLBCL, respectively. The 5-year cumulative incidences of relapse/disease progression (PD) and non-relapse mortality were 25% and 39% for all pts, 10% and 22% for FL, 24% and 13% for TL, and 50% and 67% for DLBCL, respectively. Grade III-IV acute GVHD occurred in 25% of all pts, and OS was significantly worse in such pts [hazard ratio (HR) 2.5 (95%CI 1.2–5.3), p=0.02]. Extensive chronic GVHD (cGVHD) occurred in 53% of pts who survived 100 days or longer, and OS for patients with extensive cGVHD was significantly worse than that in pts without extensive cGVHD [HR 4.5 (1.3-15.6), p=0.02]. The cause of death included PD in 10 pts, GVHD in 5, infection in 4, non-infectious lung complication in 5, cerebral infarction or hemorrhage in 2, and unknown in 3. No pts with FL died of PD, and no pts with TL who had survived for 7 months after HCT relapsed thereafter. By a multivariate analysis, the OS for DLBCL was significantly worse than that of TL [HR 4.8 (1.7-13.2), p=0.002]. OS for FL was not significantly different from that of TL [HR 0.74 (0.2-2.4), p=0.6]. Other factors that influenced OS were aaIPI at HCT [high or high-intermediate risk, HR 3.7 (1.6-8.5), p=0.002] and the serum albumin level at HCT [<4 g/dL, HR 2.4 (1.1-5.5), p=0.03]. Conclusion: In the rituximab era, pts with TL showed more favorable outcomes after allo-HCT compared to those with DLBCL, and there was no significant difference in OS between FL and TL. AaIPI and the serum albumin level at HCT may be useful surrogate markers that influence OS for pts with B-NHL after allo-HCT. Allo-HCT, mainly with the use of a RIC regimen, might be a promising option for pts with relapsed or refractory FL and TL. Disclosures: No relevant conflicts of interest to declare.

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Clinical significance of fibrinogen and albumin score for postoperative recurrence in esophageal cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.14 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 14-14 ◽

Cited By ~ 2

Author(s):

Satoru Matsuda ◽

Hiroya Takeuchi ◽

Kazumasa Fukuda ◽

Rieko Nakamura ◽

Tsunehiro Takahashi ◽

...

Keyword(s):

Esophageal Cancer ◽

Serum Albumin ◽

Cancer Patients ◽

Serum Albumin Level ◽

Fibrinogen Level ◽

Postoperative Recurrence ◽

Albumin Level ◽

Plasma Fibrinogen ◽

Plasma Fibrinogen Level ◽

Cutoff Value

14 Background: In order to predict the postoperative recurrence in esophageal cancer patients, we previously reported that esophageal cancer patients who had preoperative hyperfibrinogenemia (>350 mg/dl) showed high recurrence rate. Currently, combining the preoperative plasma fibrinogen level and serum albumin level, we established a new scoring system. In this study, we aim to clarify the validity of the fibrinogen and albumin score (FA score) in esophageal cancer patients. Methods: We retrospectively reviewed 215 patients who underwent curative transthoracic esophagectomy in our institution between January 2004 and August 2012. Preoperative plasma fibrinogen level and serum albumin level were confirmed in 204 patients. We investigated patient characteristics, clinicopathological factors, preoperative plasma fibrinogen level and plasma albumin level. Based on our previous reports, we defined a cutoff value of fibrinogen as 350 mg/dl. The cut off value of albumin was determined after the analysis of the albumin distribution in the present study. Prognostic score was constructed by assigning one point for hyperfibrinogenemia or hypoalbuminemia. Cumulative FA score was obtained by combining them. Results: Based on the result that preoperative serum albumin level was 4.1 ± 0.34 g/dl (mean ± SD), we defined a cutoff value of albumin as 4.0 g/dl. Approximately, 33% had hyperfibrinogenemia and 34% had hypoalbuminemia. The number of each FA score 0/1/2 was 98(48%)/75(37%)/31(15%) cases. The patients with advanced stage showed significantly high score. In survival univariate analysis, neoadjuvant treatment, depth of tumor invasion, lymph node metastasis, pretreatment stage, preoperative fibrinogen level and FA score were significantly correlated with postoperative disease free survival. In multivariate analysis, pretreatment stage and FA score were shown to predict postoperative DFS significantly. Conclusions: FA score was shown to predict postoperative recurrence in esophageal cancer patients. Both fibrinogen and albumin are popular indicators routinely measured in daily clinical practice, FA score may be highly validate and feasible.

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A prospective cohort study of hypoalbuminemia as risk factor of wound healing in diabetic foot: a study from tertiary hospital in south India

International Surgery Journal ◽

10.18203/2349-2902.isj20173903 ◽

2017 ◽

Vol 4 (9) ◽

pp. 3141

Author(s):

Unnikrishnan Edakkepuram ◽

Sheeja P. C. ◽

Ellikunnel Vithon Gopi

Keyword(s):

Wound Healing ◽

Risk Factor ◽

Cohort Study ◽

Serum Albumin ◽

Prospective Cohort Study ◽

Diabetic Foot ◽

Prospective Cohort ◽

Serum Albumin Level ◽

Albumin Level ◽

Low Serum

Background: Diabetic foot ulcers is a major complication of diabetes mellitus, and precedes >80% of all diabetes related lower leg amputations. One of the risk factors in non-healing diabetic ulcer is low serum albumin level. The objectives of this study were to study the effect of low serum albumin level in patients with diabetic foot ulcer and to study the factors affecting wound healing in diabetic ulcer.Methods: Prospective cohort study in a tertiary hospital.Results: The mean age among study was 57.8 out of which 68.3% were males and 31.7% were females. 55% patients presented with slough over ulcer, 29.2% patients presented with healthy granulation and 15.8% patients presented with extensive wound infection. Among study group 50% patients had good glycaemic control and 50% patients had poor glycaemic control.Conclusions: Low serum albumin level is one of the attributable risk factor of non-healing ulcers in diabetic foot. Poor glycaemic status is also a risk factor for non-healing ulcer.

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Exploring the malnutrition status and impact of total parenteral nutrition on the outcome of patients with advanced stage ovarian cancer

BMC Cancer ◽

10.1186/s12885-021-08537-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xin Yan ◽

Sanyuan Zhang ◽

Junmei Jia ◽

Jiaolin Yang ◽

Yilai Song ◽

...

Keyword(s):

Ovarian Cancer ◽

Parenteral Nutrition ◽

Serum Albumin ◽

Total Parenteral Nutrition ◽

Cancer Patients ◽

Serum Albumin Level ◽

Albumin Level ◽

Cancer Type ◽

Advanced Stage ◽

Hospitalization Period

Abstract Background Ovarian cancer is a common cancer type in women and is often associated with onset of malnutrition. Total parenteral nutrition (TPN) is a nutritional intervention method that has been reported to have controversial effect on cancer patients. In the present retrospective study, we sought to explore the prevalence of malnutrition assessed by the Nutritional Risk Index (NRI) and its association with survival in advanced stage ovarian cancer patients. We also compared the post-operative outcome of the malnourished patients treated with either TPN or conservative management. Results A total of 415 patients with advanced stage ovarian cancer were separated into 4 nutrition groups based on the NRI scores. We found that a number of factors were significantly different among the 4 nutrition groups, including age, serum albumin level, BMI and NRI; among which serum albumin level and NRI were identified to be independent predictors of progression-free and overall survival. In the moderately and severely malnourished patients, those who were treated with TPN had significantly shorter hospitalization period, lower serum albumin level and lower BMI after surgery. In addition, serum albumin level, use of TPN and number of patients with complications were closely related to the hospital stay duration. Conclusion Malnutrition status is closely associated with survival of advanced stage ovarian cancer patients. These patients may benefit from TPN treatment for reduced hospitalization, especially with the onset of hypoalbuminemia.

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Minimally Invasive Versus Open Surgery for Radical Hysterectomy Followed By Adjuvant Radiotherapy in Intermediate- or High-Risk Early-Stage Cancer of The Cervix: A Retrospective Study

10.21203/rs.3.rs-830000/v1 ◽

2021 ◽

Author(s):

Qi-ying Zhang ◽

Zi Liu ◽

Ya-li Wang ◽

Jing Zhang ◽

Wen Li ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

High Risk ◽

Minimally Invasive ◽

Cancer Patients ◽

Radical Hysterectomy ◽

Early Stage ◽

Time Interval ◽

Significant Difference ◽

The Impact

Abstract Background Postoperative radiotherapy (RT) or chemoradiotherapy (CRT) improves outcomes of cervical cancer patients with risk factors. Minimally invasive surgery (MIS) has an inferior survival than open radical hysterectomy (ORH), however, the impact of MIS on postoperative RT remains uncertain. The study compared the impacts of MIS versus ORH on delivering of adjuvant RT or CRT for intermediate- or high-risk early-stage cervical cancer. Methods Data on stage IB1-IIA2 patients who underwent radical hysterectomy and postoperative RT/CRT in our institution, from 2014 to 2017, were retrospectively collected. Patients with high or intermediate-risk factors who met the Sedlis criteria received postoperative pelvic external beam radiotherapy (50Gy/25f) with platinum-based chemotherapy (0–6 cycles) according to guidelines. Disease-free survival (DFS) and overall survival (OS) were compared in the two surgical groups. Results One hundred and twenty-nine patients eligible for the study (68 in ORH; 61 in MIS groups) had similar clinicopathologic features except for the stage (highest in MIS was IB1; IIA1 in ORH) and presence of lymph vascular space invasion (higher in MIS group). The median time interval from surgery to chemotherapy and to RT was shorter in the MIS group. Three-year DFS and OS were similar in both groups. Further sub-analysis indicated that the DFS and OS in intermediate/high-risk groups had no significant difference. Cox-multivariate analyses found that tumor size > 4 cm and time interval from surgery to RT beyond seven weeks were adverse independent prognostic factors for DFS. Conclusions In early-stage (IB1-IIA2) cervical cancer patients with intermediate or high-risk factors who received postoperative RT or CRT, no matter they received ORH or MIS as their primary treatment, the DFS and OS had no significant difference, despite TI from surgery to postoperative adjuvant therapy being shorter in the MIS group than ORH.

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