Comparison of Minimally Invasive Surgery and Abdominal Surgery Among Patients With Cervical Cancer

Ratiu, Dominik; Luncescu, Christian; Morgenstern, Bernd; Eichler, Christian; Grüttner, Berthold; Ludwig, Sebastian; Mallmann, Peter; Thangarajah, Fabinshy

doi:10.21873/anticanres.13390

Cited by 11 publications

(12 citation statements)

References 9 publications

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“…The results of this study are consistent with those reported by Dominik R and Paika, but both studies were single‐center studies with fewer cases 23, 24 . This study used the advantage of a large number of cases from a large database of cervical cancer for 1:1 matching of the factors affecting the tumor prognosis.…”

Section: Discussionsupporting

confidence: 88%

Comparison of survival outcomes between laparoscopic surgery and abdominal surgery for radical hysterectomy as primary treatment in patients with stage IB2/IIA2 cervical cancer

Chen

Guo

Liu

et al. 2021

J of Obstet and Gynaecol

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Objective To investigate the long‐term oncological outcomes of laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for the treatment of stage IB2/IIA2 cervical cancer without preoperative adjuvant therapy. Methods We conducted a multicenter, retrospective, case‐matching study. The differences in overall survival (OS) and disease‐free survival (DFS) between the LRH and ARH were compared under the conditions of real‐world study and case–control matching (1:1 matching). Results There was no significant difference in the outcomes of LRH (n = 580) and ARH (n = 1653) in 5‐year OS and DFS (OS: 80.6% vs. 86.1%, p = 0.421; DFS: 78.6% vs. 80.7%, p = 0.376). After 1:1 matching, there was no difference in 5‐year OS and DFS between LRH (n = 554) and ARH (n = 554) (OS: 80.4% vs. 84.5%, p = 0.993; DFS: 79.0% vs. 78.8%, p = 0.695). Before and after matching, the surgical approach was not an independent risk factor for 5‐year OS and DFS, and postoperative adjuvant therapy affected patient prognosis. Further subgroup analysis suggested that there was no difference in LRH (n = 313) and ARH (n = 1092) in 5‐year OS or DFS in patients who underwent standard postoperative adjuvant therapy (OS: 83.0% vs. 87.7%, p = 0.992; DFS: 79.0% vs. 82.5%, p = 0.323). After 1:1 pairing, the 5‐year OS and DFS in LRH (n = 295) and ARH (n = 295) showed no difference. Before and after matching, the surgical approach was not an independent risk factor affecting the 5‐year OS and DFS. Conclusions There was no difference in the oncological outcomes between laparoscopic and abdominal surgery in patients with stage IB2/IIA2 cervical cancer without preoperative adjuvant therapy. Clinical Trials The ethical approval number is NFEC‐2017‐135, and the clinical research registration number is CHiCTR1800017778 (International Clinical Trials Registry Platform Search Port, http://apps.who.int/trialsearch/).

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Section: Discussionsupporting

confidence: 88%

Comparison of survival outcomes between laparoscopic surgery and abdominal surgery for radical hysterectomy as primary treatment in patients with stage IB2/IIA2 cervical cancer

Chen

Guo

Liu

et al. 2021

J of Obstet and Gynaecol

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“…In neonates, it requires an extremely high level of expertise for both the surgeon and anesthesiologists. With this approach, an improved outcome was shown in other diseases (13)(14)(15). Enhanced recovery after surgery (ERAS) or 'fast-track' methods enable standardization of postoperative medical care, improvement of patient outcomes, promotion of early recovery, and reduction of healthcare expenditure.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Surgery for Congenital Abdominal Cystic Lesions in Newborns and Infants

Gałązka

Redloch

Kroczek

et al. 2020

In Vivo

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Background/Aim: In the variety of congenital abdominal cystic lesions (CACL) of different origin, ovarian cyst is the most common intra-abdominal pathology in female neonates. The prognosis and timing of treatment varies depending on the nature of CACL. This study aimed to assess the results of diagnostics and treatment of CACL. Patients and Methods: A retrospective analysis was performed of 39 cases of CACL, with the spectrum including ovarian, enteric, mesenteric and pancreatic origin. Outcome of minimally invasive surgery, open surgery or conservative approach was analyzed. Results: Twenty-eight neonates underwent surgery, while 11 were treated conservatively. Twenty patients were treated with a laparoscopic technique and eight with laparotomy combined with laparoscopy. Final diagnosis included: Fifteen cases of ovarian pathology (ovarian torsion in 11 cases), 12 treated laparoscopically and three with laparotomy, six enteric duplications (four laparoscopic and two laparotomic), three mesenteric cysts (one laparoscopic and two laparotomic), two pancreatic cysts (both laparoscopic only), two duodenal stenoses, including duodenal septum (both laparotomies with Heineke-Mikulicz plasty). No blood transfusion apart from two cases requiring re-laparotomy and no early complications were observed in any case; no death occurred. Conclusion: With the strategy of management based on ultrasound and laboratory data, a laparoscopically assisted minimal access approach resulted in minimal risk of complications and complete recovery in all patients, leading to exclusion of oncological risk.

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“…Differences in oncological outcomes between LRH and ARH are essential to consider and opinions vary from different studies (1, 9–20). After the consternation brought to light by the study of Ramirez et al (1), a prospective randomized international phase III trial, gynecologists began to think how do we proceed in the face of these data (33).…”

Section: Discussionmentioning

confidence: 99%

“…Studies included in our review had to meet all of the following criteria: (a) uterine cervical cancer; (b) radical hysterectomy and lymphadenectomy; (c) data including the comparison of laparotomy and laparoscopy; (d) date including oncologic survival outcomes; (e) studies published in English. In total 13 articles were included (1, 9–20) with details shown in Supplementary Table 1.…”

Section: A Reviewmentioning

confidence: 99%

Laparoscopic vs. Open Abdominal Radical Hysterectomy for Cervical Cancer: A Single-Institution, Propensity Score Matching Study in China

et al. 2019

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Study Objective: To compare the surgical and oncologic outcomes between open abdomen radical hysterectomy (ARH) and laparoscopic radical hysterectomy (LRH) for cervical cancer.Methods: Retrospective observational study with propensity score matching was used to ensure balanced groups for ARH and LRH. One-hundred-and-ninety-eight women with cervical cancer, 99 treated using ARH and 99 using LRH, between January 2012 and December 2014. Outcomes included disease-free survival (DFS), overall survival (OS), intra-operative factors, post-operator recovery, urinary retention, and adverse events. Moreover, the inverse probability of the treatment weighting (IPTW) method was also used.Main Results: Compared with ARH, LRH was associated with a lower volume of blood loss (P < 0.001) and transfusion rate (P < 0.001), with a broader resection of the parametrium (P < 0.001). Post-operatively, the time to first flatus was shorter for LRH than ARH (P < 0.001) but the rate of urinary retention was higher for LRH (22.2%) than ARH (8.1%; P = 0.009). DFS and OS were similar between groups. By IPTW, laparoscopy was also not associated with poorer survival in terms of DFS (HR 1.52, CI 0.799–2.891, P = 0.202) or OS (HR 0.942, HR 0.425–2.09, P = 0.883).Conclusion: Compared with ARH, LRH provided better intra-operative and post-operative outcomes, with no significant difference in oncologic outcomes and survival. Urinary retention remains a clinical issue to improve with LRH. The technology of LRH has been improved in China to address the inconsistent results of oncologic outcomes in previous studies. Whether these improvements could be effective needs to be investigated in the future.

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Comparison of Minimally Invasive Surgery and Abdominal Surgery Among Patients With Cervical Cancer

Cited by 11 publications

References 9 publications

Comparison of survival outcomes between laparoscopic surgery and abdominal surgery for radical hysterectomy as primary treatment in patients with stage IB2/IIA2 cervical cancer

Comparison of survival outcomes between laparoscopic surgery and abdominal surgery for radical hysterectomy as primary treatment in patients with stage IB2/IIA2 cervical cancer

Minimally Invasive Surgery for Congenital Abdominal Cystic Lesions in Newborns and Infants

Laparoscopic vs. Open Abdominal Radical Hysterectomy for Cervical Cancer: A Single-Institution, Propensity Score Matching Study in China

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