Predictors of recurrence following laparoscopic radical hysterectomy for early-stage cervical cancer: A multi-institutional study

被引：42

作者：

Casarin, J. ^{[1
]}

Buda, A. ^{[2
]}

Bogani, G. ^{[3
]}

Fanfani, F. ^{[4
,5
]}

Papadia, A. ^{[6
,7
,8
]}

Ceccaroni, M. ^{[9
]}

Malzoni, M. ^{[10
]}

Pellegrino, A. ^{[11
]}

Ferrari, F. ^{[12
]}

Greggi, S. ^{[13
]}

Uccella, S. ^{[14
,15
]}

Pinelli, C. ^{[1
]}

Cromi, A. ^{[1
]}

Ditto, A. ^{[3
]}

Di Martino, G. ^{[2
]}

Anchora, L. Pedone ^{[4
]}

Falcone, F. ^{[10
,13
]}

Bonfiglio, F. ^{[16
]}

Odicino, F. ^{[12
]}

Mueller, M. ^{[6
,7
]}

Scambia, G. ^{[4
,5
]}

Raspagliesi, F. ^{[3
]}

Landoni, F. ^{[2
]}

Ghezzi, F. ^{[1
]}

机构：

[1] Univ Insubria, Obstet & Gynecol Dept, Varese, Italy

[2] Univ Milano Bicocca, Dept Obstet & Gynecol, Azienda Osped San Gerardo, Monza, Italy

[3] Fdn IRCCS Ist Nazl Tumori, Gynecol Oncol, Milan, Italy

[4] Univ Cattolica Sacro Cuore, Dipartimento Sci Vita & Sanita Pubbl, Rome, Italy

[5] Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Salute Donna Bambino & Sanita Pubbl, Rome, Italy

[6] Univ Hosp Bern, Dept Obstet & Gynecol, Bern, Switzerland

[7] Univ Bern, Bern, Switzerland

[8] Univ Italian Switzerland USI, Dept Gynecol & Obstet, Ente Osped Cantonale Lugano, Lugano, Switzerland

[9] IRCCS Osped Sacro Cuore Don Calabria, Dept Obstet & Gynecol, Gynecol Oncol & Minimally Invas Pelv Surg, Verona, Italy

[10] Ctr Adv Endoscop Gynecol Surg, Endoscop Malzoni, Avellino, Italy

[11] Osped Alessandro Manzoni, Dept Obstet & Gynaecol, Lecce, Italy

[12] Spedali Civili Brescia, Dept Obstet & Gynecol, Brescia, Italy

[13] Fdn G Pascale, Dept Gynecol Oncol, IRCCS, Ist Nazl Tumori, Naples, Italy

[14] Osped Inferm Biella, Dept Obstet, Biella, Italy

[15] Osped Inferm Biella, Dept Gynecol, Biella, Italy

[16] Univ Basel, Dept Biomed, Basel, Switzerland

来源：

GYNECOLOGIC ONCOLOGY | 2020年 / 159卷 / 01期

关键词：

Laparoscopy; Cervical cancer; Minimally invasive surgery; IACC; Recurrence; Predictors; MORBIDITY; SURVIVAL; OUTCOMES;

D O I：

10.1016/j.ygyno.2020.06.508

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective. To assess predictors of recurrence following laparoscopic radical hysterectomy (LRH) for apparent early stage cervical cancer (CC). Methods. This is a retrospective multi-institutional study reviewing data of consecutive patients who underwent LRH for FIGO 2009 stage IA1 (with lyrnphovascular space invasion (LVSI)), IA2 and IB1(<= 4 cm) CC, between January 2006 and December 2017. The following histotypes were included: squamous, adenosquamous, and adenocarcinoma. Multivariable models were used to estimate adjusted odds ratio (OR) and corresponding 95% Cl. Factors influencing disease-free survival (DFS) and disease-specific survival (DSS) were also explored. Results. 428 patients were included in the analysis. With a median follow-up of 56 months (1-162) 54 patients recurred (12.6%). At multivariable analysis, tumor size (OR:1.04, 95%CI:1.01-1.09, p = .02), and presence of cervical residual tumor at final pathology (OR: 5.29, 95%CI:1.34-20.76, p = .02) were found as predictors of recurrence: conversely preoperative conization reduced the risk (OR:0.32, 95%CI:0.11-0.90, p = .03). These predictors remained significant also in the IB1 subgroup: tumor size: OR:1.05, 95%CI:1.01-1.09, p = .01; residual tumor at final pathology: OR: 6.26, 95%CI:1.58-24.83, p = .01; preoperative conization: OR:0.33, 95% CI:0.12-0.95, p = .04. Preoperative conization (HR: 0.29, 95%CI: 0.13-0.91; p = .03) and the presence of residual tumor on the cervix at the time of surgery (HR: 8.89; 95%CI:1.39-17.23; p = .01) independently correlated with DFS. No independent factors were associated with DSS. Conclusions. In women with early stage CC the presence of high-volume disease at time of surgery represent an independent predictor of recurrence after LRH. Conversely, preoperative conization and the absence of residual disease at the time of surgery might play a protective role. (C) 2020 Elsevier Inc. All rights reserved.

引用

页码：164 / 170

页数：7

共 27 条

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