Comparison of survival outcomes with or without Para-aortic lymphadenectomy in surgical patients with stage IB1-IIA2 cervical cancer in China from 2004 to 2016

Chen, Chunlin; Duan, Hui; Zhang, Wenling; Zhao, Hongwei; Wang, Li; Kang, Shan; Lin, Lihong; Zhang, Weidong; Ni, Yan; Li, Donglin; Chen, Jiaming; Fan, Huijian; Chen, Xiaolin; Bin, Xiaonong; Lang, Jinghe; Liu, Ping

doi:10.1186/s12885-021-08797-2

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…The overall grasp of the visual field avoids the omission of small active bleeding foci in the surgical field of view, and can effectively stop bleeding in time, thereby significantly reducing the amount of bleeding on the surgical wound and avoiding the occurrence of major bleeding. [46][47][48] The results of this study have showed that the time of the time to the first passage of flatus in the LRH is earlier than that of ARH. The possible reason for the difference may be that laparoscopic surgery avoids the touch of the abdominal retractor, gauze and operator's gloves on the intestine, and the less intestinal tract manipulations in the LRH reduce irritation to the patient's gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 61%

“…When the laparoscopic eyepiece is retreated, the surgical field of view can be expanded, and the operator’s awareness of the operation can be improved. The overall grasp of the visual field avoids the omission of small active bleeding foci in the surgical field of view, and can effectively stop bleeding in time, thereby significantly reducing the amount of bleeding on the surgical wound and avoiding the occurrence of major bleeding 46–48…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Versus Abdominal Radical Hysterectomy for Cervical Cancer

Zhang¹,

Song²

2022

American Journal of Clinical Oncology

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Background: Laparoscopic radical hysterectomy (LRH) and open abdominal radical hysterectomy (ARH) have been used for cervical cancer treatment. We aimed to perform a meta-analysis to compare the efficacy and safety of LRH and ARH in the treatment of cervical cancer to provide reliable evidence to the clinical cervical cancer treatment.Methods: Two investigators independently searched PubMed and other databases for randomized controlled trials (RCTs) comparing LRH and ARH for cervical cancer treatment up to May 31, 2022. The risk of bias assessment tool recommended by Cochrane library was used for quality assessment. RevMan 5.3 software was used for meta-analysis.Results: Fourteen RCTs with a total of 1700 patients with cervical cancer were finally included. Meta-analyses indicated that compared with ARH, LRH reduced the intraoperative blood loss (mean difference [MD]

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Laparoscopic Versus Abdominal Radical Hysterectomy for Cervical Cancer

Zhang¹,

Song²

2022

American Journal of Clinical Oncology

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“…However, contrary to the purely surgical group, where lymphadenectomy may follow SLN, in these cases, the SLN alone may be useful to select patients but may not guarantee the patient the curative benefit related to lymphadenectomy. [43][44][45] Moreover, patients undergoing NACT will complete their FST with surgical techniques that are as minimally invasive as possible. The goal of this approach is to minimize surgical morbidity and improve fertility outcomes, which were not the subject of this review.…”

Section: Discussionmentioning

confidence: 99%

Fertility-Sparing Treatment for Early-Stage Cervical Cancer ≥ 2 cm: A Problem with a Thousand Nuances—A Systematic Review of Oncological Outcomes

et al. 2022

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Background Fertility-sparing treatments (FSTs) have played a crucial role in the management of early-stage cervical cancer (ECC). The guidelines have recognized various approaches, depending on the tumor stage and other risk factors such as histotype and lymphovascular positivity. Much more debate has centered around the boundary within which these treatments should be considered. Indeed, these are methods to be reserved for ECC, but tumor size may represent the most significant limitation. In particular, there is no consensus on the strategy to be adopted in the case of ECC ≥ 2 cm. Therefore, this systematic review was to collect the literature evidence regarding the management of these patients. Methods Following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the Pubmed and Scopus databases was conducted in April 2022, from the date of the first publication. We made no limitation on the country. We included all studies containing data on disease-free survival, overall survival, recurrence rate (RR), or complete response rate (CRR) to chemotherapy. Results Twenty-six studies fulfilled the inclusion criteria, and 691 patients were analyzed regarding FST. Surgery-based FST showed an RR of between 0 and 42.9%, which drops to 12.9% after excluding the vaginal or minimally invasive approaches. Furthermore, papers regarding FST based on the neoadjuvant chemotherapy (NACT) approach showed a CRR of between 21.4 and 84.5%, and an RR of between 0 and 22.2% Conclusion This paper focused on the significant heterogeneity present in the clinical management of FST of ECC ≥ 2 cm. Nevertheless, from an oncological point of view, approaches limited to the minimally invasive or vaginal techniques showed the highest RR. Vice versa, the lack of standardization of NACT schemes and the wealth of confounders to be attributed to the histological features of the tumor make it difficult, if not impossible, to set a standard of treatment.

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“…All original data were reviewed and validated by two independent gynecologists to ensure the accuracy. The details of case collection in the Four-C study database is as shown in our previous studies [ 5 – 7 ]. In accordance with the journal’s guidelines, we will provide our data for the reproducibility of this study in other centers if such is requested.…”

Section: Methodsmentioning

confidence: 99%

Treatment of FIGO 2018 stage IIIC cervical cancer with different local tumor factors

Ye,

Li,

Kang

et al. 2023

BMC Cancer

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Background To compare the oncological outcomes of patients with FIGO 2018 stage IIIC cervical cancer (CC) involving different local tumor factors who underwent abdominal radical hysterectomy (ARH), neoadjuvant chemotherapy and radical surgery (NACT), or radical chemoradiotherapy (R-CT). Methods Based on tumor staging, patients with stage IIIC were divided into T1, T2a, T2b, and T3 groups. Kaplan–Meier and Cox proportional hazards regression analysis were used to compare their overall survival (OS) and disease-free survival (DFS) of 5 years. Results We included 4,086 patients (1,117, 1,019, 869, and 1,081 in the T1, T2a, T2b, and T3 groups, respectively). In the T1 group, NACT was correlated with a decrease in OS (hazard ratio [HR] = 1.631, 95% confidence interval [CI]: 1.150–2.315, P = 0.006) and DFS (HR = 1.665, 95% CI: 1.255–2.182, P < 0.001) than ARH. ARH and NACT were not correlated with OS (P = 0.226 and P = 0.921) or DFS (P = 0.343 and P = 0.535) than R-CT. In the T2a group, NACT was correlated with a decrease in OS (HR = 1.454, 95% CI: 1.057–2.000, P = 0.021) and DFS (HR = 1.529, 95% CI: 1.185–1.974, P = 0.001) than ARH. ARH and NACT were not correlated with OS (P = 0.736 and P = 0.267) or DFS (P = 0.714 and P = 0.087) than R-CT. In the T2b group, NACT was correlated with a decrease in DFS (HR = 1.847, 95% CI: 1.347–2.532, P < 0.001) than R-CT nevertheless was not correlated with OS (P = 0.146); ARH was not correlated with OS (P = 0.056) and DFS (P = 0.676). In the T3 group, the OS rates of ARH (n = 10), NACT (n = 18), and R-CT (n = 1053) were 67.5%, 53.1%, and 64.7% (P = 0.941), and the DFS rates were 68.6%, 45.5%, and 61.1%, respectively (P = 0.761). Conclusion R-CT oncological outcomes were not entirely superior to those of NACT or ARH under different local tumor factors with stage IIIC. NACT is not suitable for stage T1, T2a, and T2b. Nevertheless ARH is potentially applicable to stage T1, T2a, T2b and T3. The results of stage T3 require confirmation through further research due to disparity in case numbers in each subgroup.

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Comparison of survival outcomes with or without Para-aortic lymphadenectomy in surgical patients with stage IB1-IIA2 cervical cancer in China from 2004 to 2016

Cited by 5 publications

References 13 publications

Laparoscopic Versus Abdominal Radical Hysterectomy for Cervical Cancer

Laparoscopic Versus Abdominal Radical Hysterectomy for Cervical Cancer

Fertility-Sparing Treatment for Early-Stage Cervical Cancer ≥ 2 cm: A Problem with a Thousand Nuances—A Systematic Review of Oncological Outcomes

Treatment of FIGO 2018 stage IIIC cervical cancer with different local tumor factors

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