Long-term oncological outcomes and recurrence patterns in early-stage cervical cancer treated with minimally invasive versus abdominal radical hysterectomy: The Norwegian Radium Hospital experience.
Gynecol Oncol
; 162(2): 284-291, 2021 08.
Article
em En
| MEDLINE
| ID: mdl-34083029
ABSTRACT
OBJECTIVE:
To compare long-term oncological outcomes in early-stage cervical cancer (CC) patients treated with minimally invasive radical hysterectomy (MIRH) versus abdominal radical hysterectomy (ARH), with a focus on recurrence patterns, tumor sizes, and conization.METHODS:
This single-institution, retrospective study consisted of stage IA1-IB1 (FIGO 2009) squamous cell carcinoma, adenocarcinoma, and adenosquamous carcinoma of the cervix, who underwent radical hysterectomy between 2000 and 2017.RESULTS:
Of the 582 patients included, 353 (60.7%) underwent ARH, and 229 (39.3%) MIRH. The median follow-up was 14.4 years in the ARH group and 6.1 years in the MIRH group (p < 0.0001). Among the 96 stage IA patients, only 3 (3.1%) experienced recurrence. Among stage IB1 patients, the risk of recurrence, after adjusting for standard prognostic variables, was twofold higher in the MIRH group versus the ARH group (HR 2.73, 95% CI 1.56-4.80), and the relative difference was similar in terms of risk of cancer-specific survival (CSS) (HR 3.04, 95% CI 1.28-7.20) and overall survival (OS) (HR 2.35, 95% CI 1.21-4.59). In stage IB1 ≤ 2 cm patients without conization MIRH was associated with reduced time to recurrence (TTR) (HR 4.00, 95% CI 1.67-9.57), CSS (HR 3.71, 95% CI 1.19-11.58) and OS (HR 3.02, 95% CI 1.24-7.34). Intraperitoneal combined recurrences accounted for 12 of 30 (40.0%) recurrences in the MIRH group but were not identified after ARH (p = 0.0001).CONCLUSIONS:
MIRH was associated with reduced TTR, CSS and OS versus ARH in stage IB1 CC patients. The risk of peritoneal recurrence was high, even for tumors ≤2 cm without conization.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Epidemiologia
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Geral
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Saude_da_mulher
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Colo_do_utero
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Tipos_de_cancer
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Colo_do_utero
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Outros_tipos
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Tratamento
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Cirurgia_oncologica
Base de dados:
MEDLINE
Assunto principal:
Neoplasias do Colo do Útero
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Laparoscopia
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Conização
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Histerectomia
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Recidiva Local de Neoplasia
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Gynecol Oncol
Ano de publicação:
2021
Tipo de documento:
Article