Prognostic and Safety Roles in Laparoscopic Versus Abdominal Radical Hysterectomy in Cervical Cancer: A Meta-analysis

Cao, Tiefeng; Feng, Yanling; Huang, Qidan; Wan, Ting; Liu, Jihong

doi:10.1089/lap.2015.0390

Cited by 87 publications

(93 citation statements)

References 37 publications

(100 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As research advances, the conclusion that minimally invasive surgery has a better survival outcome than open surgery has not changed [19]; however, in 2017, conflicting survival data of minimally invasive radical hysterectomy began to be reported [11,20]. A number of recent meta-analysis studies suggested that there were no significant differences between open and minimally invasive radical hysterectomy [21][22][23][24]. However, in the study by Our results showed there was no significant difference in disease-free survival between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Impact of the Learning Curve on the Survival of Abdominal or Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

Wen

Nam

et al. 2021

Cancer Res Treat

View full text Add to dashboard Cite

The objective of this study was to define the learning curve required to attain satisfactory oncologic outcomes of cervical cancer patients who were undergoing open or minimally invasive surgery for radical hysterectomy, and to analyze the correlation between the learning curve and tumor size. Materials and Methods Cervical cancer patients (stage IA-IIA) who underwent open radical hysterectomy (n=280) or minimal invasive radical hysterectomy (n=282) were retrospectively reviewed. The learning curve was evaluated using cumulative sum of 5-year recurrence rates. Survival outcomes were analyzed based on the operation period ("learning period," P1, vs. "skilled period," P2), operation mode, and tumor size. Results The 5-year disease-free and overall survival rates between open and minimally invasive groups were 91.8% and 89.0% (p=0.098) and 96.1% and 97.2% (p=0.944), respectively. The number of surgeries for learning period was 30 and 60 in open and minimally invasive group, respectively. P2 had better 5-year disease-free survival than P1 after adjusting for risk factors (hazard ratio, 0.392; 95% confidence interval, 0.210 to 0.734, p=0.003). All patients with tumors < 2 cm had similar 5-year disease-free survival regardless of operation mode or learning curve. Minimally invasive group presented lower survival rates than open group when tumors ≥2 cm in P2. Preoperative conization improved disease-free survival in patients with tumors ≥2 cm, especially in minimally invasive group. Conclusion Minimally invasive radical hysterectomy required more cases than open group to achieve CANCER RESEARCH AND TREATMENT (CRT) 3 Korean Cancer Association This article is protected by copyright. All rights reserved. acceptable 5-year disease-free survival. When tumors ≥2 cm, the surgeon's proficiency affected survival outcomes in both groups.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of the Learning Curve on the Survival of Abdominal or Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

Wen

Nam

et al. 2021

Cancer Res Treat

View full text Add to dashboard Cite

show abstract

“…They found no differences in overall survival (HR=0.91, 95% CI 0.48 to 1.71, p=0.76) or in disease-free survival (HR=0.97, 95% CI 0.56 to 1.68, p=0.91) between the two approaches. Similarly, in the meta-analysis by Cao et al,6 which included 2922 patients, there were no significant differences in the disease-free survival rate, overall survival rate, and recurrence rate between the two groups. Both meta-analyses have a short follow-up time in the minimally invasive surgery group.…”

Section: Discussionmentioning

confidence: 78%

Minimally invasive radical hysterectomy: an analysis of oncologic outcomes from Hospital Italiano (Argentina)

Odetto

Puga

Saadi

et al. 2019

Int J Gynecol Cancer

View full text Add to dashboard Cite

BackgroundThe Laparoscopic Approach to Cervical Cancer (LACC) trial demonstrated a higher rate of disease recurrence and worse disease-free survival in patients who underwent minimally invasive radical hysterectomy.ObjectivesTo evaluate surgical and oncological outcome of laparoscopic radical hysterectomy performed at Hospital Italiano in Buenos Aires, Argentina.MethodsThis retrospective study included all patients with cervical cancer, 2009 FIGO stage IA1, with lymphovascular invasion to IB1 (<4 cm) who underwent a laparoscopic radical hysterectomy between June 2010 and June 2015. Patients were eligible if they had squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma, and no lymph node involvement by imaging. Patients must have undergone a type C1 radical hysterectomy. Only patients who were treated by a laparoscopic approach were included. Patients were excluded if histopathology showed a component of neuroendocrine carcinoma before or after surgery; if they had synchronous primary tumors, history of abdominal or pelvic radiotherapy, or were operated on at an outside institution; and if they had only surgery and no follow-up in our institution. Relapse rate and disease-free survival were evaluated using the Kaplan-Meier method.ResultsA total of 108 patients were evaluated. The median age was 41 years (range 27–70). Distribution of histologic sub-types was squamous carcinoma in 77 patients (71%), adenocarcinoma in 27 patients (25%), and adenosquamous carcinoma in four patients (4%). Ninety-nine patients (92%) had stage IB1 tumors and 58 (54%) patients had tumors ≤2 cm. The median surgical time was 240 min (range 190–290), the median estimated blood loss was 140 mL (range 50–500) and the transfusion rate was 3.7%. The median length of hospital stay was 2 days (range 1–11). The median follow-up time was 39 months (range 11–83). The global recurrence rate after laparoscopic radical hysterectomy was 15% (16/108). According to tumor size, the recurrence rate was 12% in patients with tumors ≤2 cm (7/58) and 18% in patients with tumors >2 cm (9/50) (OR=0.76; 95% CI 0.26 to 2.22; p=0.62) The 3- and 5-year relapse rate was 17% (95% CI 11% to 27%). The 3- and 5-year disease-free survival was 81% (95% CI 71% to 88%) and 70% (95% CI 43% to 86%), respectively. Overall survival at 3 years was 87% (95% CI 76% to 93%).ConclusionThe recurrence rate after laparoscopic radical hysterectomy was 15%, and in tumors ≤2 cm it was 12%. The 3-year disease-free survival was 81%. Given these results our hospital has changed the approach to open radical hysterectomy.

show abstract

“…Surgery was conducted according to the surgeon's routine. Before colpotomy, peritoneal ICG contamination was controlled . Intracorporal colpotomy was performed in four steps (anterior, left, right, posterior).…”

Section: Methodsmentioning

confidence: 99%

Peritoneal contamination with ICG‐stained cervical secretion as surrogate for potential cervical cancer tumor cell dissemination: A proof‐of‐principle study for laparoscopic hysterectomy

Klapdor

Hertel

Hillemanns

et al. 2019

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Introduction Intracorporal colpotomy during radical hysterectomy for cervical cancer is discussed to be a risk factor for peritoneal dissemination of tumor cells. It might lead to increased recurrence rates after laparoscopic radical hysterectomy compared with abdominal hysterectomy, as shown by the recent LACC study. Data on the frequency or mechanisms of peritoneal contamination are missing. We aimed to analyze peritoneal contamination of cervical secretion during intracorporal colpotomy with a novel indocyaningreen (ICG)‐based technique. Material and methods In this prospective proof‐of‐principle study, patients undergoing routine laparoscopic or robot‐assisted hysterectomy were selected. ICG was specifically applied to the cervical surface and routine surgery was performed. During colpotomy, pictures under white and fluorescence light were taken to evaluate frequency of contamination. Results By using cervically applied ICG we were able to visualize directly peritoneal contamination with cervical secretion during intracorporal colpotomy. We detected peritoneal contamination in 9/12 (75%) patients undergoing routine laparoscopic hysterectomy. Contamination of laparoscopic instruments occurred in 60% of the patients. When contamination occurred, it was routinely detectable during all steps of colpotomy. There were no adverse effects during surgery. Conclusions Peritoneal contamination with cervical secretion frequently occurs during intracorporal colpotomy. This novel technique represents a promising tool for feasible and direct visualization of peritoneal contamination during colpotomy. The technique may be easily implemented in further studies on laparoscopic and abdominal hysterectomy and serve as a quality assessment tool for surgeons and surgical techniques.

show abstract

Prognostic and Safety Roles in Laparoscopic Versus Abdominal Radical Hysterectomy in Cervical Cancer: A Meta-analysis

Cited by 87 publications

References 37 publications

Impact of the Learning Curve on the Survival of Abdominal or Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

Impact of the Learning Curve on the Survival of Abdominal or Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer

Minimally invasive radical hysterectomy: an analysis of oncologic outcomes from Hospital Italiano (Argentina)

Peritoneal contamination with ICG‐stained cervical secretion as surrogate for potential cervical cancer tumor cell dissemination: A proof‐of‐principle study for laparoscopic hysterectomy

Contact Info

Product

Resources

About