Preoperative Conization and Risk of Recurrence in Patients Undergoing Laparoscopic Radical Hysterectomy for Early Stage Cervical Cancer: A Multicenter Study.

Casarin, Jvan; Bogani, Giorgio; Papadia, Andrea; Ditto, Antonino; Pinelli, Ciro; Garzon, Simone; Donadello, Nicoletta; Laganà, Antonio Simone; Cromi, Antonella; Mueller, Michael; Raspagliesi, Francesco; Ghezzi, Fabio (2021). Preoperative Conization and Risk of Recurrence in Patients Undergoing Laparoscopic Radical Hysterectomy for Early Stage Cervical Cancer: A Multicenter Study. Journal of minimally invasive gynecology, 28(1), pp. 117-123. Elsevier 10.1016/j.jmig.2020.04.015

[img] Text
32320800.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (568kB) | Request a copy

STUDY OBJECTIVE

To investigate the factors associated with poorer oncologic outcomes in patients undergoing laparoscopic radical hysterectomy (LRH) for early stage cervical cancer.

DESIGN

Multicenter retrospective study.

SETTING

Three gynecologic oncology referral centers.

PATIENTS

Patients with International Federation of Gynecology and Obstetrics 2009 stage IA (positive lymphovascular space invasion)-IB1 cervical cancer between January 2006 and June 2018.

INTERVENTIONS

LRH (Piver type II-III hysterectomies). Lymph-node dissection was accomplished according to the tumor characteristics.

MEASUREMENTS AND MAIN RESULTS

Surgical and oncologic outcomes were analyzed. Overall, 186 patients met the inclusion criteria, 16 (8.6%) experienced a recurrence, and 9 (4.8%) died of the disease (median follow-up period 37.9 months). Surgery-related complications did not influence disease-free survival. All the recurrences (16/16; 100%) occurred in patients with stage IB1 disease (p = .02), and 15 (93.7%) in cases involving tumors ≥2 cm. No association between positive lymph node and recurrence was detected (p =.82). Patients who had a preoperative diagnosis through conization (93; 50%) had a significantly lower rate of recurrence than those who underwent cervical biopsy (93; 50%): 1/93 (1.1%) vs 15/93 (16.1%); p <.001). The subanalysis of patients with International Federation of Gynecology and Obstetrics stage IB1 cervical cancer showed that patients undergoing preoperative conization (vs cervical biopsy) were less likely to experience a recurrence (odds ratio 0.09; 95% confidence interval 0.01-0.55).

CONCLUSION

We confirmed that LRH was associated with a recurrence rate similar to that reported in the Laparoscopic Approach to Cervical Cancer trial. Tumor size ≥2 cm represents the most important risk factor influencing disease-free survival. However, we found that preoperative conization plays a potentially protective role in patients with an IB1 tumor.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Papadia, Andrea and Mueller, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1553-4650

Publisher:

Elsevier

Language:

English

Submitter:

Monika Zehr

Date Deposited:

18 Jan 2021 08:52

Last Modified:

18 Jan 2021 08:52

Publisher DOI:

10.1016/j.jmig.2020.04.015

PubMed ID:

32320800

BORIS DOI:

10.48350/150109

URI:

https://boris.unibe.ch/id/eprint/150109

Actions (login required)

Edit item Edit item
Provide Feedback