Tayfun Toptas1, Tayup Simsek. 1. Division of Gynecologic Oncological Surgery, Department of Obstetrics and Gynecology, Akdeniz University Hospital , Antalya, Turkey .
Abstract
BACKGROUND: Few reports have examined the impact of laparoscopic approach on survival outcomes in patients with early-stage (IA2-IB1) cervical cancer (CC). In this study we aimed to compare disease recurrence and survival outcomes of total laparoscopic radical hysterectomy (TLRH) with those for open radical hysterectomy (ORH) and pelvic lymphadenectomy in patients with early-stage CC. PATIENTS AND METHODS: A single-center, retrospective analysis was conducted in a total of 68 patients who treated with TLRH (n=22) or ORH (n=46) between 2007 and 2010. The primary endpoint of the study was progression-free survival (PFS). RESULTS: Median follow-up time was 42.50 months (range, 38.40-55.42 months) for the TLRH group and 43.50 months (range, 37.66-52.65) for the ORH group. The study groups were comparable in terms of baseline characteristics except the ORH group had more patients with tumor size greater than 2 cm (P=.026), depth of stromal invasion greater than 33% (P<.0001), and International Federation of Gynecology and Obstetrics stage IB1 disease (P=.019). However, these factors had no impact on overall and PFS in Cox regression analyses. In total, three recurrences were observed in the TLRH group. Two of the 3 patients were alive with no evidence of disease, and the remaining individual was alive with disease (AWD). In the ORH group, 5 patients had recurrences. Two of the 5 patients died of disease, and three were AWD. The estimated 3-year PFS (86.1% versus 90.6%, respectively; P=.32) and overall survival (100% vs. 95.4%, respectively; P=.82) were comparable in the TLRH and ORH groups. CONCLUSIONS: TLRH and ORH have similar survival outcomes in patients with early-stage CC.
BACKGROUND: Few reports have examined the impact of laparoscopic approach on survival outcomes in patients with early-stage (IA2-IB1) cervical cancer (CC). In this study we aimed to compare disease recurrence and survival outcomes of total laparoscopic radical hysterectomy (TLRH) with those for open radical hysterectomy (ORH) and pelvic lymphadenectomy in patients with early-stage CC. PATIENTS AND METHODS: A single-center, retrospective analysis was conducted in a total of 68 patients who treated with TLRH (n=22) or ORH (n=46) between 2007 and 2010. The primary endpoint of the study was progression-free survival (PFS). RESULTS: Median follow-up time was 42.50 months (range, 38.40-55.42 months) for the TLRH group and 43.50 months (range, 37.66-52.65) for the ORH group. The study groups were comparable in terms of baseline characteristics except the ORH group had more patients with tumor size greater than 2 cm (P=.026), depth of stromal invasion greater than 33% (P<.0001), and International Federation of Gynecology and Obstetrics stage IB1 disease (P=.019). However, these factors had no impact on overall and PFS in Cox regression analyses. In total, three recurrences were observed in the TLRH group. Two of the 3 patients were alive with no evidence of disease, and the remaining individual was alive with disease (AWD). In the ORH group, 5 patients had recurrences. Two of the 5 patients died of disease, and three were AWD. The estimated 3-year PFS (86.1% versus 90.6%, respectively; P=.32) and overall survival (100% vs. 95.4%, respectively; P=.82) were comparable in the TLRH and ORH groups. CONCLUSIONS: TLRH and ORH have similar survival outcomes in patients with early-stage CC.
Authors: Roni Nitecki; Pedro T Ramirez; Michael Frumovitz; Kate J Krause; Ana I Tergas; Jason D Wright; J Alejandro Rauh-Hain; Alexander Melamed Journal: JAMA Oncol Date: 2020-07-01 Impact factor: 31.777