OBJECTIVE: To compare the oncologic outcomes of women who underwent a fertility-sparing radical trachelectomy (RT) to those who underwent a radical hysterectomy (RH) for stage IB1 cervical carcinoma. METHODS: We performed a case-control study of all patients with stage IB1 cervical carcinoma who underwent a vaginal or abdominal RT between 11/01 and 6/07. The control group consisted of patients with stage IB1 disease who underwent an RH between 11/91 and 6/07 and who would be considered candidates for fertility-sparing surgery. Information was extracted from a prospectively acquired database. Recurrence-free and disease-specific survival (RFS and DSS) were estimated using Kaplan-Meier estimates and compared with the log-rank test where indicated. Multivariate analysis was performed using the Cox regression method. RESULTS: Forty stage IB1 patients underwent an RT and 110 patients underwent an RH. There were no statistical differences between the two groups for the following prognostic variables: histology, median number of lymph nodes removed, node positive rate, lymph-vascular space involvement (LVSI), or deep stromal invasion (DSI). The median follow-up for the entire group was 44 months. The 5-year RFS rate was 96% (for the RT group compared to 86% for the RH group (P=NS). On multivariate analysis in this group of stage IB1 lesions, tumor size <2 cm was not an independent predictor of outcome, but both LVSI and DSI retained independent predictive value (P=0.033 and 0.005, respectively). CONCLUSION: For selected patients with stage IB1 cervical cancer, fertility-sparing radical trachelectomy appears to have a similar oncologic outcome to radical hysterectomy. LVSI and DSI appear to be more valuable predictors of outcome than tumor diameter in this subgroup of patients.
OBJECTIVE: To compare the oncologic outcomes of women who underwent a fertility-sparing radical trachelectomy (RT) to those who underwent a radical hysterectomy (RH) for stage IB1 cervical carcinoma. METHODS: We performed a case-control study of all patients with stage IB1 cervical carcinoma who underwent a vaginal or abdominal RT between 11/01 and 6/07. The control group consisted of patients with stage IB1 disease who underwent an RH between 11/91 and 6/07 and who would be considered candidates for fertility-sparing surgery. Information was extracted from a prospectively acquired database. Recurrence-free and disease-specific survival (RFS and DSS) were estimated using Kaplan-Meier estimates and compared with the log-rank test where indicated. Multivariate analysis was performed using the Cox regression method. RESULTS: Forty stage IB1patients underwent an RT and 110 patients underwent an RH. There were no statistical differences between the two groups for the following prognostic variables: histology, median number of lymph nodes removed, node positive rate, lymph-vascular space involvement (LVSI), or deep stromal invasion (DSI). The median follow-up for the entire group was 44 months. The 5-year RFS rate was 96% (for the RT group compared to 86% for the RH group (P=NS). On multivariate analysis in this group of stage IB1 lesions, tumor size <2 cm was not an independent predictor of outcome, but both LVSI and DSI retained independent predictive value (P=0.033 and 0.005, respectively). CONCLUSION: For selected patients with stage IB1 cervical cancer, fertility-sparing radical trachelectomy appears to have a similar oncologic outcome to radical hysterectomy. LVSI and DSI appear to be more valuable predictors of outcome than tumor diameter in this subgroup of patients.
Authors: Gloria Salvo; Pedro T Ramirez; Charles F Levenback; Mark F Munsell; Elizabeth D Euscher; Pamela T Soliman; Michael Frumovitz Journal: Gynecol Oncol Date: 2017-02-08 Impact factor: 5.482
Authors: Hiroko Machida; Rachel S Mandelbaum; Mikio Mikami; Takayuki Enomoto; Yukio Sonoda; Brendan H Grubbs; Richard J Paulson; Lynda D Roman; Jason D Wright; Koji Matsuo Journal: Am J Obstet Gynecol Date: 2018-08-21 Impact factor: 8.661
Authors: N D Fleming; P T Ramirez; P T Soliman; K M Schmeler; G B Chisholm; A M Nick; S N Westin; M Frumovitz Journal: Gynecol Oncol Date: 2016-10-11 Impact factor: 5.482
Authors: Jeanne Carter; Yukio Sonoda; Raymond E Baser; Leigh Raviv; Dennis S Chi; Richard R Barakat; Alexia Iasonos; Carol L Brown; Nadeem R Abu-Rustum Journal: Gynecol Oncol Date: 2010-11 Impact factor: 5.482
Authors: Jill H Tseng; Alessia Aloisi; Yukio Sonoda; Ginger J Gardner; Oliver Zivanovic; Nadeem R Abu-Rustum; Mario M Leitao Journal: Int J Gynecol Cancer Date: 2018-09 Impact factor: 3.437
Authors: Stephanie L Wethington; Yukio Sonoda; Kay J Park; Kaled M Alektiar; William P Tew; Dennis S Chi; Mario M Leitao; Elizabeth L Jewell; Richard R Barakat; Nadeem R Abu-Rustum Journal: Int J Gynecol Cancer Date: 2013-07 Impact factor: 3.437