Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery?
| Autor: | Pere Fusté, Núria Agustí, Pilar Paredes, Jaume Ordi, Sergi Vidal-Sicart, Blanca Gil-Ibáñez, Berta Díaz-Feijoo, Marta del Pino, Angels Rovirosa, Núria Carreras, Jaume Pahisa, Ariel Glickman, Carlos Nicolau, Adela Saco, Lydia Gaba, Aureli Torné |
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| Rok vydání: | 2020 |
| Předmět: |
Cancer Research
medicine.medical_specialty cervical cancer Sentinel lymph node lcsh:RC254-282 Article Radical vaginal hysterectomy 03 medical and health sciences 0302 clinical medicine Biopsy medicine 030212 general & internal medicine Radical Hysterectomy Stage (cooking) minimally invasive surgery laparoscopically assisted radical vaginal hysterectomy Cervical cancer medicine.diagnostic_test business.industry Mortality rate medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Surgery laparoscopy/robotic-assisted surgery medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis radical hysterectomy Vagina business |
| Zdroj: | Cancers, Vol 13, Iss 846, p 846 (2021) Cancers Volume 13 Issue 4 |
| ISSN: | 2072-6694 |
| Popis: | Simple Summary Some recently published studies in early-stage cervical cancer patients have shown that minimally invasive surgery (MIS), including laparoscopic and robotic approaches, might offer lower survival rates than classic open surgery. We evaluated the oncological results of a series of patients treated by laparoscopically assisted radical vaginal hysterectomy (LARVH), an infrequently used MIS technique. We included 115 patients with early-stage cervical cancer (IA1 with lymphovascular invasion, IA2, IB1, and IIA < 2 cm; International Federation of Gynecology (FIGO), 2008). The 3- and 4.5-year disease-free survival rates were 96.7% and 93.5%, respectively, and the overall survival was 97.8% and 94.8%, respectively. These survival data are comparable with those reported with the open radical hysterectomy but presented the advantages of MIS. LARVH offers excellent disease control in women with early-stage cervical cancer and can be considered as an adequate MIS alternative to open radical hysterectomy. Abstract Background: Recent evidence indicates that some minimally invasive surgery approaches, such as laparoscopic and robotic-assisted radical hysterectomy, offer lower survival rates to patients with early-stage cervical cancer than open radical hysterectomy. We evaluated the oncological results of a different minimally invasive surgery approach, that of laparoscopically assisted radical vaginal hysterectomy (LARVH) in this setting. Methods: From January 2001 to December 2018, patients with early-stage cervical cancer were treated by LARVH. Colpotomy and initial closure of the vagina were performed following the Schauta operation, avoiding manipulation of the tumor. Laparoscopic sentinel lymph node (SLN) biopsy was performed in all cases. Women treated between 2001 and 2011 also underwent pelvic lymphadenectomy. Results: There were 115 patients included. Intraoperative complications occurred in nine patients (7.8%). After a median follow-up of 87.8 months (range 1–216), seven women (6%) presented recurrence. Four women died (mortality rate 3.4%). The 3- and 4.5-year disease-free survival rates were 96.7% and 93.5%, respectively, and the overall survival was 97.8% and 94.8%, respectively. Conclusion: LARVH offers excellent disease-free and overall survival in women with early-stage cervical cancer and can be considered as an adequate minimally invasive surgery alternative to open radical hysterectomy. |
| Databáze: | OpenAIRE |
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