Fertility-Sparing Surgery versus Radical Hysterectomy in Early Cervical Cancer: A Propensity Score Matching Analysis and Noninferiority Study
| Autor: | Antoni, Llueca, Maria Victoria, Ibañez, Aureli, Torne, Antonio, Gil-Moreno, Angel, Martin-Jimenez, Berta, Diaz-Feijoo, Anna, Serra, Maria Teresa, Climent, Blanca, Gil-Ibañez, On Behalf Of The Spain-Gog Cervical Cancer Working Group |
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| Přispěvatelé: | Institut Català de la Salut, [Llueca A] Multidisciplinary Unit of Abdominopelvic Oncology Surgery (MUAPOS), Department of Obstetrics and Gynaecology, University General Hospital of Castellon, Castellón, Spain. Department of Medicine, University Jaume I (UJI), Castelló de la Plana, Spain. [Ibañez MV] Department of Mathematics, University Jaume I (UJI), Castelló de la Plana, Spain. [Torne A, Diaz-Feijoo B] Unit of Gynaecologic Oncology (ICGON), Endocrinology, Gynaecology and Human Reproduction (IDIBAPS), Hospital Clinic of Barcelona, Barcelona, Spain. [Gil-Moreno A] Servei de Ginecologia Oncològica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Centro de Investigación Biomedica en Red de Cancer, Barcelona, Spain. [Martin-Jimenez A] Hospital Universitario Son Llatzer, Mallorca, Spain, Vall d'Hebron Barcelona Hospital Campus |
| Rok vydání: | 2022 |
| Předmět: |
trachelectomy
early cervical cancer fertility preservation treatment minimally invasive surgery radical hysterectomy fertility-sparing surgery intervenciones quirúrgicas::procedimientos quirúrgicos mínimamente invasivos [TÉCNICAS Y EQUIPOS ANALÍTICOS DIAGNÓSTICOS Y TERAPÉUTICOS] Coll uterí - Càncer - Cirurgia Medicine (miscellaneous) Otros calificadores::Otros calificadores::/cirugía [Otros calificadores] intervenciones quirúrgicas::procedimientos quirúrgicos urogenitales::procedimientos quirúrgicos ginecológicos::histerectomía [TÉCNICAS Y EQUIPOS ANALÍTICOS DIAGNÓSTICOS Y TERAPÉUTICOS] Neoplasms::Neoplasms by Site::Urogenital Neoplasms::Genital Neoplasms Female::Uterine Neoplasms::Uterine Cervical Neoplasms [DISEASES] Surgical Procedures Operative::Urogenital Surgical Procedures::Gynecologic Surgical Procedures::Hysterectomy [ANALYTICAL DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT] Surgical Procedures Operative::Minimally Invasive Surgical Procedures [ANALYTICAL DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT] Histerectomia Cirurgia endoscòpica neoplasias::neoplasias por localización::neoplasias urogenitales::neoplasias de los genitales femeninos::neoplasias uterinas::neoplasias del cuello uterino [ENFERMEDADES] Other subheadings::Other subheadings::/surgery [Other subheadings] |
| Zdroj: | Journal of Personalized Medicine; Volume 12; Issue 7; Pages: 1081 Scientia |
| ISSN: | 2075-4426 |
| Popis: | Early cervical cancer; Fertility-sparing surgery; Radical hysterectomy Cáncer de cuello uterino temprano; Cirugía conservadora de la fertilidad; Histerectomía radical Càncer de coll uterí precoç; Cirurgia conservadora de la fertilitat; Histerectomia radical Objective: Fertility-sparing surgery (FSS) is the treatment of choice for patients with early cervical cancer (ECC) and fertility desire, but survival rates compared to radical hysterectomy (RH) have been scarcely reported. The aim of this study was to analyse the oncological outcomes of FSS compared to a balanced group of standard RH. Methods: A retrospective multicentre study of ECC patients who underwent FSS or RH was carried out in 12 tertiary hospitals in Spain between January 2005 and January 2019. The experimental group included patients who underwent a simple and radical trachelectomy, and the control group included patients who underwent RH. Optimal 1:1 propensity score (PS) matching analysis was performed to balance the series. Results: The study included 222 patients with ECC; 111 (50%) were treated with FSS, and 111 (50%) were treated with RH. After PS matching, a total of 38 patients in the FSS group and 38 patients in the RH group were analysed. In both groups, the overall survival (HR 2.5; CI 0.89, 7.41) and recurrence rates (28.9% in the FSS group vs. 13.2% in RH group) were similar. The rate of disease-free survival at 5 years was 68.99% in the FSS group and 88.01% in the RH group (difference of −19.02 percentage points; 95% CI −32.08 to −5.96 for noninferiority). In the univariate analysis, only tumour size reached statistical significance. Conclusion: FSS offers excellent disease-free and overall survival in women with ECC with fertility desire and is not inferior compared to RH. This work received financial support from the Medtronic University Chair for Training and Surgical Research, University Jaume I (UJI), Castellon, Spain. |
| Databáze: | OpenAIRE |
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