Evaluation of Surgical Outcomes of Abdominal Radical Hysterectomy and Total Laparoscopic Radical Hysterectomy for Cervical Cancer: A Retrospective Analysis of Data Collected before the LACC Trial
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Tsikouras, P.; Zervoudis, S.; Manav, B.; Tomara, E.; Iatrakis, G.; Romanidis, C.; Bothou, A.; Galazios, G. Cervical cancer: Screening, diagnosis and staging. J. Buon Off. J. Balk. Union Oncol. 2016, 21, 320–325. [Google Scholar]
- D’Oria, O.; Corrado, G.; Laganà, A.S.; Chiantera, V.; Vizza, E.; Giannini, A. New Advances in Cervical Cancer: From Bench to Bedside. Int. J. Environ. Res. Public Health 2022, 19, 7094. [Google Scholar] [CrossRef]
- Shrestha, A.D.; Neupane, D.; Vedsted, P.; Kallestrup, P. Cervical Cancer Prevalence, Incidence and Mortality in Low and Middle Income Countries: A Systematic Review. Asian Pac. J. Cancer Prev. APJCP 2018, 19, 319–324. [Google Scholar] [CrossRef]
- Scioscia, M.; Noventa, M.; Palomba, S.; Laganà, A.S. Effect of the COVID-19 pandemic on oncology screenings: It is time to change course. BJOG Int. J. Obstet. Gynaecol. 2021, 128, 2213–2214. [Google Scholar] [CrossRef]
- Brucker, S.Y.; Ulrich, U.A. Surgical Treatment of Early-Stage Cervical Cancer. Oncol. Res. Treat. 2016, 39, 508–514. [Google Scholar] [CrossRef]
- Wang, Y.; Deng, L.; Xu, H.; Zhang, Y.; Liang, Z. Laparoscopy versus laparotomy for the management of early stage cervical cancer. BMC Cancer 2015, 15, 928. [Google Scholar] [CrossRef] [Green Version]
- Bogani, G.; Cromi, A.; Uccella, S.; Serati, M.; Casarin, J.; Pinelli, C.; Nardelli, F.; Ghezzi, F. Nerve-sparing versus conventional laparoscopic radical hysterectomy: A minimum 12 months’ follow-up study. Int. J. Gynecol. Cancer Off. J. Int. Gynecol. Cancer Soc. 2014, 24, 787–793. [Google Scholar] [CrossRef]
- Ramirez, P.T.; Frumovitz, M.; Pareja, R.; Lopez, A.; Vieira, M.; Ribeiro, R.; Buda, A.; Yan, X.; Shuzhong, Y.; Chetty, N.; et al. Minimally Invasive versus Abdominal Radical Hysterectomy for Cervical Cancer. N. Engl. J. Med. 2018, 379, 1895–1904. [Google Scholar] [CrossRef]
- Melamed, A.; Ramirez, P.T. Changing treatment landscape for early cervical cancer: Outcomes reported with minimally invasive surgery compared with an open approach. Curr. Opin. Obstet. Gynecol. 2020, 32, 22–27. [Google Scholar] [CrossRef]
- Park, J.Y.; Nam, J.H. How should gynecologic oncologists react to the unexpected results of LACC trial? J. Gynecol. Oncol. 2018, 29, e74. [Google Scholar] [CrossRef]
- von Elm, E.; Altman, D.G.; Egger, M.; Pocock, S.J.; Gøtzsche, P.C.; Vandenbroucke, J.P.; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. Int. J. Surg. Lond. Engl. 2014, 12, 1495–1499. [Google Scholar] [CrossRef]
- Koh, W.-J.; Greer, B.E.; Abu-Rustum, N.R.; Apte, S.M.; Campos, S.M.; Chan, J.; Cho, K.R.; Cohn, D.; Crispens, M.A.; DuPont, N.; et al. Cervical cancer. J. Natl. Compr. Cancer Netw. JNCCN 2013, 11, 320–343. [Google Scholar] [CrossRef] [Green Version]
- Chuang, L.T.; Temin, S.; Camacho, R.; Dueñas-Gonzalez, A.; Feldman, S.; Gultekin, M.; Gupta, V.; Horton, S.; Jacob, G.; Kidd, E.A.; et al. Management and Care of Women with Invasive Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Clinical Practice Guideline. J. Glob. Oncol. 2016, 2, 311–340. [Google Scholar] [CrossRef]
- Young, J.; Badgery-Parker, T.; Dobbins, T.; Jorgensen, M.; Gibbs, P.; Faragher, I.; Jones, I.; Currow, D. Comparison of ECOG/WHO performance status and ASA score as a measure of functional status. J. Pain Symptom Manag. 2015, 49, 258–264. [Google Scholar] [CrossRef]
- Scandurra, G.; Scibilia, G.; Banna, G.L.; D’Agate, G.; Lipari, H.; Gieri, S.; Scollo, P. Efficacy and tolerability of paclitaxel, ifosfamide, and cisplatin as a neoadjuvant chemotherapy in locally advanced cervical carcinoma. J. Gynecol. Oncol. 2015, 26, 118–124. [Google Scholar] [CrossRef] [Green Version]
- Nishino, M. Tumor Response Assessment for Precision Cancer Therapy: Response Evaluation Criteria in Solid Tumors and Beyond. Am. Soc. Clin. Oncol. Educ. Book Am. Soc. Clin. Oncol. Annu. Meet. 2018, 38, 1019–1029. [Google Scholar] [CrossRef]
- Querleu, D.; Morrow, C.P. Classification of radical hysterectomy. Lancet Oncol. 2008, 9, 297–303. [Google Scholar] [CrossRef]
- Cibula, D.; Abu-Rustum, N.R. Pelvic lymphadenectomy in cervical cancer--surgical anatomy and proposal for a new classification system. Gynecol. Oncol. 2010, 116, 33–37. [Google Scholar] [CrossRef]
- Cao, L.; Wen, H.; Feng, Z.; Han, X.; Zhu, J.; Wu, X. Role of adjuvant therapy after radical hysterectomy in intermediate-risk, early-stage cervical cancer. Int. J. Gynecol. Cancer Off. J. Int. Gynecol. Cancer Soc. 2021, 31, 52–58. [Google Scholar] [CrossRef]
- Okazawa, M.; Mabuchi, S.; Isohashi, F.; Suzuki, O.; Yoshioka, Y.; Sasano, T.; Ohta, Y.; Kamiura, S.; Ogawa, K.; Kimura, T. Impact of the addition of concurrent chemotherapy to pelvic radiotherapy in surgically treated stage IB1-IIB cervical cancer patients with intermediate-risk or high-risk factors: A 13-year experience. Int. J. Gynecol. Cancer Off. J. Int. Gynecol. Cancer Soc. 2013, 23, 567–575. [Google Scholar] [CrossRef]
- Röseler, J.; Wolff, R.; Bauerschlag, D.O.; Maass, N.; Hillemanns, P.; Ferreira, H.; Debrouwere, M.; Scheibler, F.; Geiger, F.; Elessawy, M. Challenges and Controversies in the Surgical Treatment of Cervical Cancer: Open Radical Hysterectomy versus Minimally Invasive Radical Hysterectomy. J. Clin. Med. 2021, 10, 3761. [Google Scholar] [CrossRef]
- Dos Reis, R.; Andrade, C.E.M.C.; Frumovitz, M.; Munsell, M.; Ramirez, P.T. Radical Hysterectomy and Age: Outcomes Comparison Based on a Minimally Invasive vs an Open Approach. J. Minim. Invasive Gynecol. 2018, 25, 1224–1230. [Google Scholar] [CrossRef] [PubMed]
- George, E.M.; Tergas, A.I.; Ananth, C.V.; Burke, W.M.; Lewin, S.N.; Prendergast, E.; Neugut, A.I.; Hershman, D.L.; Wright, J.D. Safety and tolerance of radical hysterectomy for cervical cancer in the elderly. Gynecol. Oncol. 2014, 134, 36–41. [Google Scholar] [CrossRef] [Green Version]
- Park, J.-Y.; Kim, D.-Y.; Kim, J.-H.; Kim, Y.-M.; Kim, Y.-T.; Nam, J.-H. Laparoscopic versus open radical hysterectomy for elderly patients with early-stage cervical cancer. Am. J. Obstet. Gynecol. 2012, 207, 195.e1. [Google Scholar] [CrossRef] [PubMed]
- Malzoni, M.; Tinelli, R.; Cosentino, F.; Fusco, A.; Malzoni, C. Total laparoscopic radical hysterectomy versus abdominal radical hysterectomy with lymphadenectomy in patients with early cervical cancer: Our experience. Ann. Surg. Oncol. 2009, 16, 1316–1323. [Google Scholar] [CrossRef]
- Bogani, G.; Cromi, A.; Serati, M.; Di Naro, E.; Uccella, S.; Donadello, N.; Ghezzi, F. Predictors of postoperative morbidity after laparoscopic versus open radical hysterectomy plus external beam radiotherapy: A propensity-matched comparison. J. Surg. Oncol. 2014, 110, 893–898. [Google Scholar] [CrossRef] [PubMed]
- van de Lande, J.; von Mensdorff-Pouilly, S.; Lettinga, R.G.; Piek, J.M.; Verheijen, R.H.M. Open versus laparoscopic pelvic lymph node dissection in early stage cervical cancer: No difference in surgical or disease outcome. Int. J. Gynecol. Cancer Off. J. Int. Gynecol. Cancer Soc. 2012, 22, 107–114. [Google Scholar] [CrossRef]
- Bogani, G.; Cromi, A.; Uccella, S.; Serati, M.; Casarin, J.; Pinelli, C.; Ghezzi, F. Laparoscopic versus open abdominal management of cervical cancer: Long-term results from a propensity-matched analysis. J. Minim. Invasive Gynecol. 2014, 21, 857–862. [Google Scholar] [CrossRef]
- Ghezzi, F.; Cromi, A.; Ditto, A.; Vizza, E.; Malzoni, M.; Raspagliesi, F.; Uccella, S.; Corrado, G.; Cosentino, F.; Gotsch, F.; et al. Laparoscopic versus open radical hysterectomy for stage IB2-IIB cervical cancer in the setting of neoadjuvant chemotherapy: A multi-institutional cohort study. Ann. Surg. Oncol. 2013, 20, 2007–2015. [Google Scholar] [CrossRef]
- Leitao, M.M., Jr.; Zhou, Q.C.; Brandt, B.; Iasonos, A.; Sioulas, V.; Lavigne Mager, K.; Shahin, M.; Bruce, S.; Black, D.R.; Kay, C.G.; et al. The MEMORY Study: MulticentEr study of Minimally invasive surgery versus Open Radical hYsterectomy in the management of early-stage cervical cancer: Survival outcomes. Gynecol. Oncol. 2022, 166, 417–424. [Google Scholar] [CrossRef]
- Giannini, A.; D’Oria, O.; Chiantera, V.; Margioula-Siarkou, C.; Di Donna, M.C.; Terzic, S.; Sleiman, Z.; Laganà, A.S. Minimally Invasive Surgery for Cervical Cancer: Should We Look beyond Squamous Cell Carcinoma? J. Investig. Surg. Off. J. Acad. Surg. Res. 2022, 35, 1602–1603. [Google Scholar] [CrossRef] [PubMed]
Radicality 1 | ARH, n (%) | TLRH, n (%) |
---|---|---|
A | 1 (1.4) | 0 (0) |
B1 | 1 (1.4) | 4 (10) |
B2 | 0 (0) | 4 (10) |
C1 | 62 (86.1) | 26 (65) |
C2 | 6 (8.3) | 0 (0) |
Mixed | 2 (2.8) | 6 (15) |
Total | 72 (100) | 40 (100) |
Parameter | ARH (n = 72) | TLRH (n = 40) | p |
---|---|---|---|
Age (mean ± SD) | 53.1 ± 12.2 | 48.9 ± 11.9 | 0.0798 |
Body Mass Index (Kg/m2) | 26.2 ± 4.9 | 25.5 ± 5.1 | 0.4825 |
Parity | 2.1 ± 1.5 | 2.3 ± 1.6 | 0.5189 |
Stage | ARH, n (%) | TLRH, n (%) |
---|---|---|
IA1 | 1 (1.4) | / |
IA2 | 1 (1.4) | 5 (12.5) |
IB1 | 16 (22.2) | 15 (37.5) |
IB2 | 5 (6.9) | 2 (5) |
IIA | 4 (5.6) | / |
IIB | 45 (62.5) | 18 (45) |
Histology | ||
Squamous cell carcinoma | 57 (79.2) | 23 (57.5) |
Adenocarcinoma | 12 (16.7) | 11 (27.5) |
Adenosquamous | 1 (1.4) | 1 (2.5) |
Not specified | 1 (1.4) | 5 (12.5) |
Grade | ||
G1 | 0 (0) | 1 (2.5) |
G2 | 19 (26.4) | 11 (27.5) |
G3 | 13 (18.1) | 18 (20) |
Not specified | 40 (55.6) | 19 (47.5) |
Surgical Variables | ARH (n = 72) | TLRH (n = 40) | p |
---|---|---|---|
Operative time (min) | 129.6 ± 25 | 242.7 ± 72.9 | <0.0001 |
Estimated blood loss (cc) | 246.8 ± 113.6 | 152 ± 72.9 | <0.0001 |
Transfusions, n (%) | 7 (9.7) | 2 (5) | 0.4863 |
Length of hospital stay (days) | 6 ± 2.7 | 5.25 ± 2.6 | 0.1529 |
Intra-operative complications, n (%) | |||
Vascular injuries | 8 (11.1) | 7 (17.5) | |
Detrusor fibers disjunction | 2 (2.8) | 2 (5) | |
Uterus perforation by manipulator | / | 1 (2.5) | |
Bowel injury | 1 (1.4) | 0 (0) | |
Conversion to laparotomy | / | 2 (5) | |
Total | 11 (15.2) | 12 (30) | 0.0874 |
Post-operative complications, n (%) | |||
Re-laparotomy | 2 (2.8) | / | |
Cardiac arrest | 1 (1.4) | 0 (0) | |
Death | 1 (1.4) | 0 (0) | |
Fever | 4 (5.6) | 2 (5) | |
Anemia | 2 (4.2) | 1 (2.5) | |
Intraoperative transfusions | 2 (2.8) | 1 (2.5) | |
Postoperative ileus | 2 (2.8) | 1 (2.5) | |
Subcutaneous emphysema | / | 1 (2.5) | |
Laparotomy wound dehiscence | 1 (1.4) | / | |
Vaginal cuff dehiscence | 0 (0) | 2 (5) | |
Vaginal leakage | 0 (0) | 1 (2.5) | |
Lymphocele/lymphocyst | 4 (5.6) | 3 (7.5) | |
Vesico-vaginal fistula | 1 (1.4) | 0 (0) | |
Ureter-vaginal fistula | 1 (1.4) | 2 (5) | |
Entero-vaginal fistula | 1 (1.4) | 2 (5) | |
Entero-cutaneous fistula | 1 (1.4) | 0 (0) | |
Thigh paresthesia | 0 (0) | 1 (2.5) | |
Voiding sequelae from denervation | 3 (4.2) | 5 (12.5) | |
Total | 26 (36.1) | 22 (55%) | 0.0727 |
ARH (n = 72) | TLRH (n = 40) | p | |
---|---|---|---|
Patients in follow-up (median 33 months) | 18 (25) | 38 (95) | |
Death | 3 (16.6) | 0 (0) | 0.5514 |
Recurrence of disease | 5 (27.8) | 0 (0) | 0.1582 |
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Pecorino, B.; D’Agate, M.G.; Scibilia, G.; Scollo, P.; Giannini, A.; Di Donna, M.C.; Chiantera, V.; Laganà, A.S. Evaluation of Surgical Outcomes of Abdominal Radical Hysterectomy and Total Laparoscopic Radical Hysterectomy for Cervical Cancer: A Retrospective Analysis of Data Collected before the LACC Trial. Int. J. Environ. Res. Public Health 2022, 19, 13176. https://doi.org/10.3390/ijerph192013176
Pecorino B, D’Agate MG, Scibilia G, Scollo P, Giannini A, Di Donna MC, Chiantera V, Laganà AS. Evaluation of Surgical Outcomes of Abdominal Radical Hysterectomy and Total Laparoscopic Radical Hysterectomy for Cervical Cancer: A Retrospective Analysis of Data Collected before the LACC Trial. International Journal of Environmental Research and Public Health. 2022; 19(20):13176. https://doi.org/10.3390/ijerph192013176
Chicago/Turabian StylePecorino, Basilio, Maria Gabriella D’Agate, Giuseppe Scibilia, Paolo Scollo, Andrea Giannini, Mariano Catello Di Donna, Vito Chiantera, and Antonio Simone Laganà. 2022. "Evaluation of Surgical Outcomes of Abdominal Radical Hysterectomy and Total Laparoscopic Radical Hysterectomy for Cervical Cancer: A Retrospective Analysis of Data Collected before the LACC Trial" International Journal of Environmental Research and Public Health 19, no. 20: 13176. https://doi.org/10.3390/ijerph192013176