Is Modified Radical Hysterectomy Needed for Patients with Clinical Stage I/II Endometrial Cancers? A Historical Control Study

Miyamoto, Morikazu; Takano, Masashi; Aoyama, Tadashi; Soyama, Hiroaki; Kato, Masafumi; Yoshikawa, Tomoyuki; Shibutani, Takashi; Matsuura, Hiroko; Gotō, Tomoko; Sasa, Hidenori; Nagaoka, Isao; Furuya, Kenichi

doi:10.1159/000444258

Cited by 5 publications

(6 citation statements)

References 24 publications

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“…In the present study, factors associated with local recurrence included stage, postmenopausal status, and histological type 2. Previous studies reported that factors related to PFS included age, tumor grade, myometrial invasion, and stage [10–12] and those affecting OS included age, tumor grade, stage, and vascular invasion [1, 11, 12, 16]. These results are similar to those of the present study.…”

Section: Discussionsupporting

confidence: 92%

“…A retrospective study conducted in Japan by Morikazu et al on SH and mRH for 247 patients with stage I and stage II endometrial cancer [12] reported the PFS and OS did not significantly differ between the groups. In a randomized controlled trial of extrafascial SH and mRH performed on 520 patients with stage I endometrial cancer, Mauro et al reported no significant difference between the two groups in terms of disease-free survival and OS [10].…”

Section: Discussionmentioning

confidence: 99%

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Does the extension of the type of hysterectomy contribute to the local control of endometrial cancer?

et al. 2019

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Objective To examine the necessity and sufficiency of different types of hysterectomy for the surgical treatment of endometrial cancer. Methods This was a multicenter collaborative study conducted by 11 institutions. Among patients with stage I–III endometrial cancer who underwent surgery as the initial treatment (only chemotherapy was provided if adjuvant therapy was needed) from 2001 to 2012, we retrospectively examined the type of hysterectomy, clinicopathological factors, recurrence rate over a maximum period of 5 years, and the site of recurrence. The local recurrence rate was examined by univariate and multivariate analyses. Results Among 1335 patients, 982 (73.6%) underwent simple hysterectomy (SH) and 353 (26.4%) underwent modified radical hysterectomy (mRH) and were observed for a mean duration of 51.8 months. No significant difference was observed in the rate of local recurrence between the SH and mRH groups ( p = 0.928). In multivariate analysis, clinicopathological factors independently associated with localized recurrence included postmenopausal status [hazard ratio (HR) 5.036, 95% confidence interval (CI) 1.506–16.841, p = 0.009], with stages II (HR 3.337, 95% CI 1.701–6.547, p < 0.001) and III (HR 2.445, 95% CI 1.280–4.668, p = 0.007), vs stage I and histological type 2 (HR 1.610, 95% CI 0.938–2.762, p = 0.001). Conclusions For endometrial cancer patients requiring surgery, the selection of a more extensive type of hysterectomy did not reduce the rate of local recurrence. Therefore, there is little significance in performing mRH in such cases.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Does the extension of the type of hysterectomy contribute to the local control of endometrial cancer?

et al. 2019

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“…The goals of this surgical management are to obtain an optimal cytoreduction and identify parametrial involvement, with the consequent change in clinical staging, prognosis, and need for adjuvancy [4]. It should be noted that radical hysterectomy carries a risk of complications that could delay adjuvancy [5]. Additionally, cervical involvement could be associated with other poor prognostic factors, such as lymphovascular invasion, unfavorable histologies, deep myometrial invasion, and ovarian and lymph node involvement [2,6,7].…”

Section: Introductionmentioning

confidence: 99%

What is the impact of radical hysterectomy on endometrial cancer with cervical involvement?

et al. 2020

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Background When endometrial carcinoma invades the cervical stroma, overall survival and disease-free survival decrease. However, it is still controversial whether patients in suspected stage II should be treated with radical hysterectomy. The goal of this study is to describe the role of radical hysterectomy in patients with endometrial carcinoma and cervical involvement. Methods This was a retrospective cohort study were a total of 239 patients with endometrial carcinoma with cervical involvement from Mexico City’s National Cancer Institute were divided according to the type of hysterectomy, and the outcomes were compared using statistical analysis. Results The 5-year overall survival was 75.76% for the simple hysterectomy group and 89.19% for the radical hysterectomy group, without achieving statistical significance. The 5-year disease-free survival was 72.95% for the simple hysterectomy group and 64.31% for the radical hysterectomy group, without achieving statistical significance. Radicality was associated with longer surgical times, intraoperative complications, and bleeding over 500 ml. Conclusions In patients with endometrial carcinoma with cervical involvement, radical hysterectomy does not improve prognosis or alter adjuvant therapy.

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“…Also, the rate of postoperative infection or the volume of blood loss may also increase. In Miyamoto's study, similar results were confirmed [19]. There was a correlation between a longer operation time and more frequent development of severe adverse events, such as blood loss and lymphedema.…”

Section: Discussionmentioning

confidence: 60%

The necessity of radical hysterectomy (RH) for pure endometrial carcinoma combined with cervical involvement: a retrospective cohort study comparing RH with total hysterectomy (TH)

Zhi-min¹,

Chen

et al. 2020

Preprint

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Objective : The purpose of this study was to explore the necessity of radical hysterectomy (RH) for patients with pure endometrial carcinoma（PEC) combined with cervical involvement by comparing with total hysterectomy (TH).Methods : A total of 162 patients who were diagnosed as PEC combined with cervical involvement of stage II and III by postoperative pathological examination between January, 2007 and December, 2017 were included in our study. Among of them, 91 were followed up till the end of this study and 71 were lost in the follow-up. In the 91 patients with complete follow-up information, 34 patients were treated with TH and 57 patients were treated with RH. The 5-year progression free survival rate, 5-year overall survival rate, recurrence rate and postoperative complications of patients were evaluated.Results : There were no significant differences in both the overall survival curve and progression free survival curve between patients with PEC receiving RH and those receiving TH (both p > 0.05). The analysis of postoperative complications showed that patients with RH treatment may have a higher probability of postoperative lymphocyst and urinary dysfunction.Conclusions : RH may not improve the prognosis of cervical involvement in patients with PEC. The postoperative complications of patients with PEC who treated with RH may increase.

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Is Modified Radical Hysterectomy Needed for Patients with Clinical Stage I/II Endometrial Cancers? A Historical Control Study

Cited by 5 publications

References 24 publications

Does the extension of the type of hysterectomy contribute to the local control of endometrial cancer?

Does the extension of the type of hysterectomy contribute to the local control of endometrial cancer?

What is the impact of radical hysterectomy on endometrial cancer with cervical involvement?

The necessity of radical hysterectomy (RH) for pure endometrial carcinoma combined with cervical involvement: a retrospective cohort study comparing RH with total hysterectomy (TH)

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