Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery?

被引:10
作者
Torne, Aureli [1 ,2 ,3 ]
Pahisa, Jaume [1 ,2 ,3 ]
Ordi, Jaume [4 ,5 ]
Fuste, Pere [1 ,3 ]
Diaz-Feijoo, Berta [1 ,2 ,3 ]
Glickman, Ariel [1 ]
Paredes, Pilar [2 ,3 ,6 ]
Rovirosa, Angels [2 ,3 ,7 ]
Gaba, Lydia [2 ,8 ]
Saco, Adela [2 ,3 ]
Nicolau, Carlos [9 ]
Carreras, Nuria [1 ]
Agusti, Nuria [1 ]
Vidal-Sicart, Sergi [2 ,6 ]
Gil-Ibanez, Blanca [10 ]
del Pino, Marta [1 ,2 ,3 ]
机构
[1] Hosp Clin Barcelona, Gynecol Oncol Unit, Clin Inst Gynecol Obstet & Neonatol, Barcelona 08036, Spain
[2] Inst Investigac Biomed August Pi & Sunyer IDIBAPS, Barcelona 08036, Spain
[3] Univ Barcelona, Surg & Med Surg Specialties Dept, Fac Med, Barcelona 08036, Spain
[4] Hosp Clin Barcelona, Dept Pathol, Barcelona 08036, Spain
[5] Univ Barcelona, Inst Salut Global Barcelona ISGlobal, Fac Med, Barcelona 08036, Spain
[6] Hosp Clin Barcelona, Dept Nucl Med, Barcelona 08036, Spain
[7] Hosp Clin Barcelona, Dept Radiat Oncol, Barcelona 08036, Spain
[8] Hosp Clin Barcelona, Dept Med Oncol, Barcelona 08036, Spain
[9] Hosp Clin Barcelona, Radiol Dept, Barcelona 08036, Spain
[10] 12 Octubre Univ Hosp, Dept Obstet & Gynecol, Gynecol Oncol & Minimally Invas Gynecol Surg Unit, Madrid 28041, Spain
关键词
cervical cancer; laparoscopically assisted radical vaginal hysterectomy; minimally invasive surgery; laparoscopy; robotic-assisted surgery; radical hysterectomy;
D O I
10.3390/cancers13040846
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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. 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.
引用
收藏
页码:1 / 13
页数:12
相关论文
共 40 条
[1]  
Abdollah F, 2019, NEW ENGL J MED, V380, P793, DOI 10.1056/NEJMc1816590
[2]   Minimally invasive surgery versus laparotomy for radical hysterectomy in the management of early-stage cervical cancer: Survival outcomes [J].
Brandt, Benny ;
Sioulas, Vasileios ;
Basaran, Derman ;
Kuhn, Theresa ;
LaVigne, Katherine ;
Gardner, Ginger J. ;
Sonoda, Yukio ;
Chi, Dennis S. ;
Roche, Kara C. Long ;
Mueller, Jennifer J. ;
Jewell, Elizabeth L. ;
Broach, Vance A. ;
Zivanovic, Oliver ;
Abu-Rustum, Nadeem R. ;
Leitao, Mario M., Jr. .
GYNECOLOGIC ONCOLOGY, 2020, 156 (03) :591-597
[3]   Prognostic and Safety Roles in Laparoscopic Versus Abdominal Radical Hysterectomy in Cervical Cancer: A Meta-analysis [J].
Cao, Tiefeng ;
Feng, Yanling ;
Huang, Qidan ;
Wan, Ting ;
Liu, Jihong .
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES, 2015, 25 (12) :990-998
[4]   SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer [J].
Chiva, Luis ;
Zanagnolo, Vanna ;
Querleu, Denis ;
Martin-Calvo, Nerea ;
Arevalo-Serrano, Juan ;
Capilna, Mihai Emil ;
Fagotti, Anna ;
Kucukmetin, Ali ;
Mom, Constantijne ;
Chakalova, Galina ;
Aliyev, Shamistan ;
Malzoni, Mario ;
Narducci, Fabrice ;
Arencibia, Octavio ;
Raspagliesi, Francesco ;
Toptas, Tayfun ;
Cibula, David ;
Kaidarova, Dilyara ;
Meydanli, Mehmet Mutlu ;
Tavares, Mariana ;
Golub, Dmytro ;
Perrone, Anna Myriam ;
Poka, Robert ;
Tsolakidis, Dimitrios ;
Vujic, Goran ;
Jedryka, Marcin A. ;
Zusterzeel, Petra L. M. ;
Beltman, Jogchum Jan ;
Goffin, Frederic ;
Haidopoulos, Dimitrios ;
Haller, Herman ;
Jach, Robert ;
Yezhova, Iryna ;
Berlev, Igor ;
Bernardino, Margarida ;
Bharathan, Rasiah ;
Lanner, Maximilian ;
Maenpaa, Minna M. ;
Sukhin, Vladyslav ;
Feron, Jean-Guillaume ;
Fruscio, Robert ;
Kukk, Kersti ;
Ponce, Jordi ;
Minguez, Jose Angel ;
Vazquez-Vicente, Daniel ;
Castellanos, Teresa ;
Chacon, Enrique ;
Alcazar, Juan Luis .
INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, 2020, 30 (09) :1269-1277
[5]   The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer [J].
Cibula, David ;
Poetter, Richard ;
Planchamp, Francois ;
Avall-Lundqvist, Elisabeth ;
Fischerova, Daniela ;
Meder, Christine Haie ;
Koehler, Christhardt ;
Landoni, Fabio ;
Lax, Sigurd ;
Lindegaard, Jacob Christian ;
Mahantshetty, Umesh ;
Mathevet, Patrice ;
McCluggage, W. Glenn ;
McCormack, Mary ;
Naik, Raj ;
Nout, Remi ;
Pignata, Sandro ;
Ponce, Jordi ;
Querleu, Denis ;
Raspagliesi, Francesco ;
Rodolakis, Alexandros ;
Tamussino, Karl ;
Wimberger, Pauline ;
Raspollini, Maria Rosaria .
RADIOTHERAPY AND ONCOLOGY, 2018, 127 (03) :404-416
[6]  
Dargent D., 1992, Journal de Gynecologie Obstetrique et Biologie de la Reproduction, V21, P709
[7]  
Dargent D., 1987, EUR J GYNAECOL ONCOL, V8, P292
[8]   Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].
Dindo, D ;
Demartines, N ;
Clavien, PA .
ANNALS OF SURGERY, 2004, 240 (02) :205-213
[9]   ESGO Survey on Current Practice in the Management of Cervical Cancer [J].
Dostalek, Lukas ;
Avall-Lundqvist, Elisabeth ;
Creutzberg, Carien L. ;
Kurdiani, Dina ;
Ponce, Jordi ;
Dostalkova, Iva ;
Cibula, David .
INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, 2018, 28 (06) :1226-1231
[10]   A TOTAL POPULATION ANALYSIS OF IN-HOSPITAL OUTCOMES OF RADICAL CYSTECTOMY IN GERMANY FROM 2006 TO 2013: IMPACT OF SURGICAL APPROACH AND ANNUAL CASELOAD VOLUME [J].
Groeben, Christer ;
Koch, Rainer ;
Baunacke, Martin ;
Wirth, Manfred ;
Huber, Johannes .
JOURNAL OF UROLOGY, 2017, 197 (04) :E725-E725