Surgical and Pathological Outcomes of Laparoscopic Versus Abdominal Radical Hysterectomy With Pelvic Lymphadenectomy and/or Para-aortic Lymph Node Sampling for Bulky Early-Stage Cervical Cancer

Zhu, Tao; Chen, Xi; Zhu, Jun; Chang, Yaqing; Yu, Aijun; Chen, Lü; Shou, Huafeng; Mei-juan, WU; Zhang, Ping

doi:10.1097/igc.0000000000000716

Cited by 17 publications

(10 citation statements)

References 27 publications

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“…10,11 Over the last 2 decades, multiple retrospective studies comparing the oncologic outcomes of MIS to those of open radical hysterectomy for the treatment of early-stage cervical cancer have reported similar rates of recurrence, death, disease-free survival (DFS), and overall survival (OS). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] However, two recent publications reported worse survival outcomes with MIS compared with laparotomy, raising concerns over the MIS approach. In a large epidemiologic retrospective national cancer database (NCDB) study in the US, Melamed et al reported shorter OS with MIS over open radical hysterectomy among patients with earlystage cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive surgery versus laparotomy for radical hysterectomy in the management of early-stage cervical cancer: Survival outcomes

Brandt

Sioulas

Başaran

et al. 2020

Gynecologic Oncology

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Objective: To compare oncologic and perioperative outcomes in patients who underwent minimally invasive surgery (MIS) compared to laparotomy for newly diagnosed early-stage cervical carcinoma. Methods:We retrospectively identified patients who underwent radical hysterectomy for stage IA1 with lymphovascular invasion (LVI), IA2, or IB1 cervical carcinoma at our institution from 1/2007-12/2017. Clinicopathologic characteristics and surgical and oncologic survival outcomes were compared using appropriate statistical testing. Multivariable Cox regression analysis was used to control for potential confounders. Results: We identified 196 evaluable cases-117 MIS (106 robotic [90.6%]) and 79 laparotomy cases. Cohorts had similar age, BMI, substage, histologic subtype, clinical and pathologic tumor

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Section: Introductionmentioning

confidence: 99%

Minimally invasive surgery versus laparotomy for radical hysterectomy in the management of early-stage cervical cancer: Survival outcomes

Brandt

Sioulas

Başaran

et al. 2020

Gynecologic Oncology

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“…Although there were no reports showing an accurate rate of an internal hernia caused by a vascular structure, it is considered to be extremely rare. In contrast, pelvic lymph node dissection has been a standard procedure for patients with prostate cancer [1], bladder cancer [2], ovarian cancer [3], and cervical cancer [4]. ePLND isolates the vessels from neighboring tissues, thus creating a potential hernial defect.…”

Section: Discussionmentioning

confidence: 99%

“…Pelvic lymph node dissection is a standard procedure in many operative treatments in cancer, such as prostate cancer [1], bladder cancer [2], ovarian cancer [3], and cervical cancer [4]. Also, a Japanese multi-institutional study clarified that extended pelvic lymph node dissection (ePLND) with skeletonization of the external iliac artery improved staging and removed a greater number of metastatic nodes in prostate cancer [5].…”

Section: Introductionmentioning

confidence: 99%

Internal hernia beneath the left external iliac artery after robotic-assisted laparoscopic prostatectomy with extended pelvic lymph node dissection: a case report

Ninomiya¹,

Amano²,

Ogawa³

et al. 2019

surg case rep

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Background Formation of an internal hernia beneath a skeletonized pelvic vessel after pelvic lymph node dissection is extremely rare. We report a case of an internal hernia formation beneath the left external iliac artery after a robotic-assisted laparoscopic prostatectomy with extended pelvic lymph node dissection. Case presentation A 72-year-old man visited our hospital complaining of severe lower abdominal pain. On physical examinations, his abdomen was distended and tympanitic with rebound tenderness and muscular defense. Abdominal non-enhanced computed tomography showed a small bowel obstruction with marked ascites. A coronal non-enhanced computed tomography image revealed thickened loops of small bowel with surrounding mesenteric edema in the left lower quadrant. Enhanced computed tomography was not performed because we decided to perform urgent surgery with a diagnosis of strangulated small bowel obstruction based on physical examination and the computed tomography findings. The patient underwent urgent laparotomy at which time bloody ascites was seen in the peritoneal cavity. The ileum, which was approximately 60 cm proximal to the ileocecal junction, formed a closed loop beneath the left external iliac artery. The incarcerated ileum, 120 cm in length, appeared non-viable with a color change of the ileum to black. We therefore resected the strangulated ileum for a length of 120 cm and performed a functional end-to-end anastomosis. The orifice beneath the left external iliac artery was about 4 cm in diameter. We did not close the orifice because of the risk of injuring the left iliac artery. The postoperative course was uneventful, and the patient was discharged from our hospital 10 days after surgery. Presently, the patient is doing well 5 months after surgery without recurrent disease. Conclusion We report an extremely rare case of internal hernia formation beneath the left external iliac artery after a robotic-assisted laparoscopic prostatectomy with extended pelvic lymphadenectomy. Awareness of such complication and early surgical treatment are important when treating patients with this rare occurrence.

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“…Since originally reported by Minelli in 1990,16 LRH has been increasingly adopted in the treatment of CC during the past few decades. A lot of studies suggested that LRH was associated with no difference in oncologic outcomes as compared with the ARH,5,11,12 and several studies revealed that LRH had better survival outcomes than the open approach 7,10. Recently, a prospective, randomized trial13 indicated that patients who underwent minimally invasive radical hysterectomy for early-stage CC had lower rates of DFS and OS than patients who underwent open ARH.…”

Section: Discussionmentioning

confidence: 99%

“…Although laparoscopic radical hysterectomy (LRH) has been widely adopted in CC patients over the past few decades, the oncologic safety of LRH in treating CC patients compared with abdominal radical hysterectomy (ARH) remains questionable 5–8. Several studies have demonstrated that neither LRH nor ARH had a significant impact on the survival outcomes in patients with early-stage CC 9–12. However, a recent prospective, randomized trial showed that minimally invasive radical hysterectomy was associated with lower rates of disease-free survival (DFS) and overall survival (OS) than open ARH among women with early-stage CC 13.…”

Section: Introductionmentioning

confidence: 99%

<p>Adverse effect of laparoscopic radical hysterectomy depends on tumor size in patients with cervical cancer</p>

Hu¹,

Ming²,

Yan³

et al. 2019

CMAR

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PurposeThe study aimed to explore the survival outcomes of early-stage cervical cancer (CC) patients treated with laparoscopic/abdominal radical hysterectomy (LRH/ARH).Patients and MethodsWe performed a retrospective analysis involving women who had undergone LRH/ARH for CC in early stage during the 2013–2015 period in West China Second University Hospital. The survival outcomes and potential prognostic factors were evaluated using Kaplan–Meier method and Cox regression analysis, respectively.ResultsA total of 678 patients were included in our analysis. The overall survival (OS) and progression-free survival (PFS) between the ARH (n=423) and LRH (n=255) groups achieved no significant differences (p=0.122, 0.285, respectively). However, in patients with a tumor diameter >4 cm, the OS of the LRH group was significantly shorter than that of the ARH group (p=0.017). Conversely, in patients with a tumor diameter ≤4 cm, the LRH group had a significantly longer OS than the ARH group (p=0.013). The multivariate Cox analysis revealed that International Federation of Gynecology and Obstetrics stage, histology, parametrial invasion, and pelvic lymph node invasion were independent prognostic factors for OS and PFS, whereas surgical method was not a statistically significant predictor of OS (p=0.806) or PFS (p=0.236) in CC patients.ConclusionLRH was an alternative to ARH for surgical treatment of CC patients with a tumor diameter ≤4 cm. However, for the patients with a tumor diameter >4 cm, priority should be given to ARH.

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Surgical and Pathological Outcomes of Laparoscopic Versus Abdominal Radical Hysterectomy With Pelvic Lymphadenectomy and/or Para-aortic Lymph Node Sampling for Bulky Early-Stage Cervical Cancer

Abstract: The surgical outcomes of LRH with pelvic lymphadenectomy and/or para-aortic lymph node sampling exhibited a similar therapeutic efficacy to those of the ARH approach.

Cited by 17 publications

References 27 publications

Minimally invasive surgery versus laparotomy for radical hysterectomy in the management of early-stage cervical cancer: Survival outcomes

Minimally invasive surgery versus laparotomy for radical hysterectomy in the management of early-stage cervical cancer: Survival outcomes

Internal hernia beneath the left external iliac artery after robotic-assisted laparoscopic prostatectomy with extended pelvic lymph node dissection: a case report

<p>Adverse effect of laparoscopic radical hysterectomy depends on tumor size in patients with cervical cancer</p>

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