Cargando…
Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery?
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 pat...
Autores principales: | , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923118/ https://www.ncbi.nlm.nih.gov/pubmed/33671382 http://dx.doi.org/10.3390/cancers13040846 |
_version_ | 1783658840929075200 |
---|---|
author | Torné, Aureli Pahisa, Jaume Ordi, Jaume Fusté, Pere Díaz-Feijóo, Berta Glickman, Ariel Paredes, Pilar Rovirosa, Angels Gaba, Lydia Saco, Adela Nicolau, Carlos Carreras, Núria Agustí, Núria Vidal-Sicart, Sergi Gil-Ibáñez, Blanca del Pino, Marta |
author_facet | Torné, Aureli Pahisa, Jaume Ordi, Jaume Fusté, Pere Díaz-Feijóo, Berta Glickman, Ariel Paredes, Pilar Rovirosa, Angels Gaba, Lydia Saco, Adela Nicolau, Carlos Carreras, Núria Agustí, Núria Vidal-Sicart, Sergi Gil-Ibáñez, Blanca del Pino, Marta |
author_sort | Torné, Aureli |
collection | PubMed |
description | 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. ABSTRACT: 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. |
format | Online Article Text |
id | pubmed-7923118 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79231182021-03-03 Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery? Torné, Aureli Pahisa, Jaume Ordi, Jaume Fusté, Pere Díaz-Feijóo, Berta Glickman, Ariel Paredes, Pilar Rovirosa, Angels Gaba, Lydia Saco, Adela Nicolau, Carlos Carreras, Núria Agustí, Núria Vidal-Sicart, Sergi Gil-Ibáñez, Blanca del Pino, Marta Cancers (Basel) Article 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. ABSTRACT: 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. MDPI 2021-02-17 /pmc/articles/PMC7923118/ /pubmed/33671382 http://dx.doi.org/10.3390/cancers13040846 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Torné, Aureli Pahisa, Jaume Ordi, Jaume Fusté, Pere Díaz-Feijóo, Berta Glickman, Ariel Paredes, Pilar Rovirosa, Angels Gaba, Lydia Saco, Adela Nicolau, Carlos Carreras, Núria Agustí, Núria Vidal-Sicart, Sergi Gil-Ibáñez, Blanca del Pino, Marta Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery? |
title | Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery? |
title_full | Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery? |
title_fullStr | Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery? |
title_full_unstemmed | Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery? |
title_short | Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery? |
title_sort | oncological results of laparoscopically assisted radical vaginal hysterectomy in early-stage cervical cancer: should we really abandon minimally invasive surgery? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923118/ https://www.ncbi.nlm.nih.gov/pubmed/33671382 http://dx.doi.org/10.3390/cancers13040846 |
work_keys_str_mv | AT torneaureli oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT pahisajaume oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT ordijaume oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT fustepere oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT diazfeijooberta oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT glickmanariel oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT paredespilar oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT rovirosaangels oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT gabalydia oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT sacoadela oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT nicolaucarlos oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT carrerasnuria oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT agustinuria oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT vidalsicartsergi oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT gilibanezblanca oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery AT delpinomarta oncologicalresultsoflaparoscopicallyassistedradicalvaginalhysterectomyinearlystagecervicalcancershouldwereallyabandonminimallyinvasivesurgery |