Jing Guo1, Ying Zhang1, Xiaofei Chen1, Lin Sun1, Kai Chen1, Xiugui Sheng2. 1. School of Medicine and Life Sciences (Drs. Guo and X. Chen), and the Department of Gynecologic Oncology (Drs. Zhang, Sun and Sheng), Shandong Cancer Hospital and Institute, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China(Drs. Guo, Zhang, X.Chen, Sun and Sheng), and the Department of Cardiothoracic Surgery, The 2nd Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China (Dr. K. Chen). 2. School of Medicine and Life Sciences (Drs. Guo and X. Chen), and the Department of Gynecologic Oncology (Drs. Zhang, Sun and Sheng), Shandong Cancer Hospital and Institute, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China(Drs. Guo, Zhang, X.Chen, Sun and Sheng), and the Department of Cardiothoracic Surgery, The 2nd Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China (Dr. K. Chen).. Electronic address: shengxiugui@163.com.
Abstract
STUDY OBJECTIVE: To compare the surgical and oncologic outcomes between abdominal radical trachelectomy (ART) and radical hysterectomy (RH) for stage IA2-IB1 cervical cancer. DESIGN: A retrospective cohort study (Canadian Task Force classification II-2). SETTING: Shandong Cancer Hospital, Shandong, China. PATIENTS: Three hundred twenty-nine patients with IA2-IB1 cervical cancer. INTERVENTIONS: All patients underwent ART or RH. MEASUREMENTS AND MAIN RESULTS: All patients were divided into ART (n = 143) and RH (n = 186) groups according to the surgical approach. Additionally, oncologic and fertility outcomes were compared for different tumor pathologies and sizes in ART patients. The ART group had similar case characteristics as the RH group, except that the ART group had a longer surgical time. During a similar follow-up period, there were 4 (2.9%) recurrences and 3 (2.2%) patients who died from recurrence in the ART group compared with 8 (4.6%) recurrences and 4 (2.3%) patients who died from recurrence in the RH group (p = .444 and p = .999, respectively). In the ART group, squamous cell carcinoma (SCC) patients had a 5-year overall survival and pregnancy rate similar to those of non-SCC patients (98.1% vs 96.8%, p = .999; 33.3% vs 26.7%, p = .873), and patients with tumors ≤2 cm and 2 to 4 cm experienced a similar 5-year overall survival rate (97.0% vs 98.6%, p = .999), except patients with tumors ≤2 cm had a higher pregnancy rate (45.2% vs 17.2%, p = .020). CONCLUSION: ART seems to have similar surgical and oncologic outcomes to RH, except ART has a longer surgical time. Both non-SCC patients and stage IA2-IB1 patients with 2- to 4-cm tumors can undergo ART safely. Patients with tumors ≤2 cm have a higher pregnancy rate than patients with 2- to 4-cm tumors.
STUDY OBJECTIVE: To compare the surgical and oncologic outcomes between abdominal radical trachelectomy (ART) and radical hysterectomy (RH) for stage IA2-IB1 cervical cancer. DESIGN: A retrospective cohort study (Canadian Task Force classification II-2). SETTING: Shandong Cancer Hospital, Shandong, China. PATIENTS: Three hundred twenty-nine patients with IA2-IB1 cervical cancer. INTERVENTIONS: All patients underwent ART or RH. MEASUREMENTS AND MAIN RESULTS: All patients were divided into ART (n = 143) and RH (n = 186) groups according to the surgical approach. Additionally, oncologic and fertility outcomes were compared for different tumor pathologies and sizes in ARTpatients. The ART group had similar case characteristics as the RH group, except that the ART group had a longer surgical time. During a similar follow-up period, there were 4 (2.9%) recurrences and 3 (2.2%) patients who died from recurrence in the ART group compared with 8 (4.6%) recurrences and 4 (2.3%) patients who died from recurrence in the RH group (p = .444 and p = .999, respectively). In the ART group, squamous cell carcinoma (SCC) patients had a 5-year overall survival and pregnancy rate similar to those of non-SCC patients (98.1% vs 96.8%, p = .999; 33.3% vs 26.7%, p = .873), and patients with tumors ≤2 cm and 2 to 4 cm experienced a similar 5-year overall survival rate (97.0% vs 98.6%, p = .999), except patients with tumors ≤2 cm had a higher pregnancy rate (45.2% vs 17.2%, p = .020). CONCLUSION:ART seems to have similar surgical and oncologic outcomes to RH, except ART has a longer surgical time. Both non-SCC patients and stage IA2-IB1 patients with 2- to 4-cm tumors can undergo ART safely. Patients with tumors ≤2 cm have a higher pregnancy rate than patients with 2- to 4-cm tumors.
Authors: Carlo Ronsini; Maria Cristina Solazzo; Nicolò Bizzarri; Domenico Ambrosio; Marco La Verde; Marco Torella; Raffaela Maria Carotenuto; Luigi Cobellis; Nicola Colacurci; Pasquale De Franciscis Journal: Ann Surg Oncol Date: 2022-09-05 Impact factor: 4.339