Oncological Outcomes of Nerve-Sparing Radical Hysterectomy for Cervical Cancer: A Systematic Review

Başaran, Derman; Dušek, Ladislav; Májek, Ondřej; Cibula, David

doi:10.1245/s10434-015-4377-7

Cited by 35 publications

(36 citation statements)

References 41 publications

(56 reference statements)

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“…The traditional radical hysterectomy should be conducted if PNI of cervical cancer was identified. However, some researchers consider tumor size <2 cm, shallow myometrial invasion, and no LVSI as the indications of NSRH (32). In the present study, our multivariate analysis identified that PNI of cervical cancer was associated with LVSI and lymph node metastasis, suggesting that LVSI and lymph node metastasis are independent risk factors for PNI.…”

Section: Discussionsupporting

confidence: 46%

“…Studies on the safety of NSRN are predominantly focused on the post-operative function of bladder and rectum and sexual activities, however, these studies have a number of limitations such as poor comparison, small sampling size, or shorter follow-up period. Whether NSRH is safer than the traditional radical hysterectomy has not yet been determined (32)(33)(34). Given that PNI of cervical cancer is associated with poor prognosis of cervical cancer patients, NSRH should be carefully recommended for cervical cancer patients with PNI.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the association between perineural invasion and clinical and histopathological features of cervical cancer

Wei

Yao

Liu

2016

Molecular and Clinical Oncology

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Abstract. Perineural invasion (PNI) has been investigated as a new prognostic factor in a number of carcinomas. However, studies on PNI in cervical cancer are limited, and inconsistent conclusions have been reported by different groups. The aim of the present study was to analyze the relationship between perineural invasion (PNI) and clinical and histopathological features of cervical cancer, and to evaluate the clinical significance of PNI of cervical cancer. Retrospective review identified 206 patients with cervical cancer who underwent radical hysterectomy plus pelvic lymphadenectomy between December 2012 and August 2014. The association between PNI and clinical and histopathological features of cervical cancer and post-operative radiotherapy was evaluated based on univariate and multivariate analyses. PNI of cervical cancer was identified in 33 of 206 (16%) cervical cancer patients. Univariate analysis demonstrated that PNI was associated with clinical stage, tumor grade, tumor size, depth of invasion, lymphovascular space invasion (LVSI), and lymph node metastasis (P<0.05), but not associated with age and histopathological types (P>0.05). Multivariate analysis suggests that LVSI and lymph node metastasis were associated with PNI of cervical cancer (P<0.05). In addition, post-operative radiotherapy was significantly more recommended for patients with PNI than those without PNI (P<0.001). In conclusion, PNI of cervical cancer is associated with LVSI and lymph node metastasis and can be used as an index for the determination of post-operative radiotherapy for cervical cancer patients.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Evaluation of the association between perineural invasion and clinical and histopathological features of cervical cancer

Wei

Yao

Liu

2016

Molecular and Clinical Oncology

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“…As Basaran and colleagues reported that there were neither adequate nor statistically relevant evidence addressing the oncologic safety of NSRH over that of RH, due to the scarcity and heterogeneity of effect estimates in different trials [8]. We focused on the recurrence rate of cervical cancer after NSRH and RH, which was regarded as a main outcome measure.…”

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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“…While splanchnic and hypogastric nerve-sparing surgery for cervical cancer (to avoid urinary dysfunction) has been a focus for many groups, the long-term data as to the desired effect are still inconclusive [52]. …”

Section: Other Approaches Under Investigationmentioning

confidence: 99%

Surgical Treatment of Early-Stage Cervical Cancer

Brucker

Ulrich

2016

Oncol Res Treat

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Surgical treatment of cervical cancer has been a cornerstone in the management of this malignancy for more than 100 years. Today, for early-stage and low-risk cervical cancer, surgery is still considered the gold standard. If the preoperative assessment of the tumor reveals a situation prompting postoperative adjuvant radiochemotherapy, the latter should be planned as the primary treatment option, being preceded by staging laparoscopy including pelvic and paraaortic lymph node dissection. As an alternative to the open approach, the definitive surgical treatment should be either performed laparoscopically, or be laparoscopic-assisted, or laparoscopically robotic-assisted.

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Oncological Outcomes of Nerve-Sparing Radical Hysterectomy for Cervical Cancer: A Systematic Review

Cited by 35 publications

References 41 publications

Evaluation of the association between perineural invasion and clinical and histopathological features of cervical cancer

Evaluation of the association between perineural invasion and clinical and histopathological features of cervical cancer

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

Surgical Treatment of Early-Stage Cervical Cancer

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