Laparoscopic Versus Open Abdominal Management of Cervical Cancer: Long-Term Results From a Propensity-Matched Analysis

Bogani, Giorgio; Cromi, Antonella; Uccella, Stefano; Serati, Maurizio; Casarin, Jvan; Pinelli, Ciro; Ghezzi, Fabio

doi:10.1016/j.jmig.2014.03.018

Cited by 104 publications

(92 citation statements)

References 21 publications

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“…Meta-analysis of these local and overall recurrence rate data didn't show significant differences after NSRH and RH procedures. Several evidence like the reviewer mentioned above did suggest that these two surgical techniques might have similar long term outcomes [33,[38][39][40][41]. So we included studies using laparotomy-based or laparoscopy-based approaches in this study and analyzed the outcomes of NSRH and RH without differentiating their specific approaches.…”

Section: Main Findingsmentioning

confidence: 99%

Comparison of Nerve-Sparing Radical Hysterectomy and Radical Hysterectomy: a Systematic Review and Meta-Analysis

Xue¹,

Zhu²,

Teng³

2016

Cell Physiol Biochem

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Background/Aims: Radical hysterectomy (RH) for the treatment of cervical cancer frequently caused pelvic organ dysfunctions. This study aimed to compare the results of pelvic organ function and recurrence rate after Nerve sparing radical hysterectomy (NSRH) and RH treatment through systematic review and meta-analysis. Methods: PubMed, Web of Science and China Knowledge Resource Integrated Database were searched from inception to 25 February 2015. Studies of cervical cancer which reported radical hysterectomy or nerve sparing radical hysterectomy were included. The quality of included studies was evaluated using the guidelines of Cochrane Handbook for Systematic Reviews of Interventions. Statistical analysis was performed using Review Manager 5.3 software (Cochrane Collaboration). Results: A total of 20 studies were finally included. Meta-analysis demonstrated that NSRH was associated with less bladder and anorectal dysfunction than RH. The time to bladder and anorectal function recovery after NSRH was shorter than RH. Patients undergoing NSRH also scored higher than patients undergoing RH at Female Sexual Function Index (FSFI). On the other hand, the local recurrence and overall recurrence rate were similar between NSRH and RH. Conclusion: NSRH may be an effective technique for lowering pelvic organ dysfunction and improving the function recovery without increasing the recurrence rate of cervical cancer.

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Section: Main Findingsmentioning

confidence: 99%

Comparison of Nerve-Sparing Radical Hysterectomy and Radical Hysterectomy: a Systematic Review and Meta-Analysis

Xue¹,

Zhu²,

Teng³

2016

Cell Physiol Biochem

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“…Since then, systematic reviews of observational studies have shown minimally invasive surgery (MIS) to be associated with a shorter hospital stay, fewer complications, less blood loss and lower transfusion rates . This is in the background of oncological safety being reported as similar in both open surgery and MIS …”

Section: Introductionmentioning

confidence: 99%

Long‐term oncological outcomes of minimally invasive radical hysterectomy for early‐stage cervical cancer: A retrospective, single‐institutional study in the wake of the LACC trial

Kawakami

Andou

Yanai

et al. 2019

J of Obstet and Gynaecol

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Aim: The objective of this study was to investigate the long-term oncological outcomes of minimally invasive radical hysterectomy (MIRH) for the treatment of early-stage cervical cancer retrospectively in the wake of the laparoscopic approach to cervical cancer (LACC) trial. Methods: A total of 109 patients with stage IA1 with lymphovascular space involvement, IA2, and IB1 cervical cancers were included in this study. The surgical and oncological outcomes were retrospectively evaluated. All patients underwent type C MIRH with a no-touch isolation technique for cervical tumor. Results: The median number of resected pelvic lymph nodes was 36 (range, 14-94), and 10 patients (9.2%) had positive nodes. One patient (0.9%) had positive surgical margins. Forty-six patients (42%) underwent adjuvant therapy. The median follow-up time was 73 months (range, 30-146 months). Five patients (4.6%) developed recurrent disease, and 3 patients (2.8%) died of cervical cancer. The 5-year disease-free survival and overall survival rates were 96.3% and 97.2%, respectively. A comparison between patients with tumor diameter ≤ 2 cm (n = 59) and those with tumor diameter > 2 cm (n = 50) did not identify any significant differences, with 5-year disease-free survival 96.6% versus 94.0% and 5-year overall survival 98.3% versus 96.0%, respectively. Conclusion: In this retrospective study, MIRH with a no-touch isolation technique for stage IA to IB1 cervical cancer was a safe approach in terms of oncological outcomes. However, every surgeon who treats early-stage cervical cancer should inform each patient of the results of the LACC trial because it has an exceedingly high impact.

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“…LRH seems to maintain its favourable therapeutic profile over ARH in other reported propensity matched cohorts [16]. A large series of 130 propensity score matched patients reported similar operative times between the two groups, supporting therefore the fact that after the introduction phase of LRH, the cost deriving from the duration of surgery is equalising [17]. …”

Section: Discussionmentioning

confidence: 80%

Safety and Cost Considerations during the Introduction Period of Laparoscopic Radical Hysterectomy

Anagnostopoulos

Decruze

Macdonald

et al. 2017

Obstetrics and Gynecology International

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Objective. To compare the safety, efficacy, and direct cost during the introduction of laparoscopic radical hysterectomy within an enhanced recovery pathway. Methods. A 1 : 1 single centre retrospective case control study of 36 propensity matched pairs of patients receiving open or laparoscopic surgery for early cervical cancer. Results. There were no significant differences in the baseline characteristics of the two cohorts. Open surgery cohort had significantly higher intraoperative blood loss (189 versus 934 mL) and longer postoperative hospital stay (2.3 versus 4.1 days). Although no significant difference in the intraoperative or postoperative complications was found more urinary tract injuries were recorded in the laparoscopic cohort. Laparoscopic surgery had significantly longer duration (206 versus 159 minutes), lower lymph node harvest (12.6 versus 16.9), and slower bladder function recovery. The median direct hospital cost was £4850 for laparoscopic radical hysterectomy and £4400 for open surgery. Conclusions. Laparoscopic radical hysterectomy can be safely introduced in an enhanced recovery environment without significant increase in perioperative morbidity. The 10% higher direct hospital cost is not statistically significant and is expected to even out when indirect costs are included.

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Laparoscopic Versus Open Abdominal Management of Cervical Cancer: Long-Term Results From a Propensity-Matched Analysis

Cited by 104 publications

References 21 publications

Comparison of Nerve-Sparing Radical Hysterectomy and Radical Hysterectomy: a Systematic Review and Meta-Analysis

Comparison of Nerve-Sparing Radical Hysterectomy and Radical Hysterectomy: a Systematic Review and Meta-Analysis

Long‐term oncological outcomes of minimally invasive radical hysterectomy for early‐stage cervical cancer: A retrospective, single‐institutional study in the wake of the LACC trial

Safety and Cost Considerations during the Introduction Period of Laparoscopic Radical Hysterectomy

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