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Tytuł:
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Investigating the possible impact of peritoneal tumor exposure amongst women with early stage cervical cancer treated with minimally invasive approach.
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Autorzy:
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Pedone Anchora L; Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy.
Bizzarri N; Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy. Electronic address: .
Kucukmetin A; Northern Gynaecological Oncology Center, Queen Elizabeth Hospital, Gateshead, United Kingdom.
Turco LC; Gemelli Molise, Dipartimento di Oncologia, UOC Ginecologia Oncologica, Campobasso, Italy; Gynecology and Brest Care Unit, Mater Olbia Hospital, Olbia, Italy.
Gallotta V; Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy.
Carbone V; Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy.
Rundle S; Northern Gynaecological Oncology Center, Queen Elizabeth Hospital, Gateshead, United Kingdom.
Ratnavelu N; Northern Gynaecological Oncology Center, Queen Elizabeth Hospital, Gateshead, United Kingdom.
Cosentino F; Gemelli Molise, Dipartimento di Oncologia, UOC Ginecologia Oncologica, Campobasso, Italy.
Chiantera V; Department of Gynecologic Oncology, University of Palermo, Palermo, Italy.
Fagotti A; Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.
Fedele C; Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy.
Gomes N; Northern Gynaecological Oncology Center, Queen Elizabeth Hospital, Gateshead, United Kingdom.
Ferrandina G; Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.
Scambia G; Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Roma, Italy.
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Źródło:
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European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2021 May; Vol. 47 (5), pp. 1090-1097. Date of Electronic Publication: 2020 Oct 03.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: : Amsterdam : Elsevier
Original Publication: London ; New York : Academic Press, [1985-
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MeSH Terms:
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Colpotomy/*adverse effects
Minimally Invasive Surgical Procedures/*adverse effects
Peritoneal Cavity/*pathology
Uterine Cervical Neoplasms/*surgery
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Italy ; Lymph Node Excision ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Prognosis ; Propensity Score ; Retrospective Studies ; Risk Factors ; Survival Rate ; Uterine Cervical Neoplasms/pathology
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Contributed Indexing:
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Keywords: Cervical cancer; Laparoscopy; Minimally invasive; Peritoneal contamination; Radical hysterectomy
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Entry Date(s):
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Date Created: 20201011 Date Completed: 20211011 Latest Revision: 20211011
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Update Code:
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20240105
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DOI:
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10.1016/j.ejso.2020.09.038
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PMID:
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33039294
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Introduction: Recent findings show a detrimental impact of the minimally invasive approach on patients with early stage cervical cancer (ECC). Reasons beyond these results are unclear. The aim of the present article is to investigate the possible role of peritoneal contamination during intracorporeal colpotomy.
Methods: patients with early stage cervical cancer were divided into 2 groups: no intraperitoneal exposure (N-IPE) intraperitoneal exposure (IPE) during minimally invasive surgery. Patients of the 2 groups were propensity-matched according to the major risk factors.
Results: 226 cases of the IPE group had a significant worst prognosis than the 142 cases of the N-IPE group (4.5-years disease free survival: 86.6% vs 95.9% respectively, p = 0.005), while N-IPE had similar survival to open surgery (4.5-years disease free survival: 95.0% vs 90.5% respectively, p = 0.164). Distant recurrence was more frequent among IPE patients with a borderline significance (3.5% vs 0.4% among IPE and N-IPE respectively, p = 0.083). On multivariate analysis, intraperitoneal tumor exposure was an independent prognostic factors for worse survival; patients belonging to the N-IPE group had a risk of recurrence of about 3-fold lower compared to patients of the IPE group (hazard ratio: 0.37, 95% confidence interval: 0.15-0.88, p = 0.025).
Conclusion: it would be advisable that further prospective studies investigating the efficacy of different surgical approach in ECC take into consideration of this issue. Moreover, all other measures that could potentially prevent peritoneal exposure of tumor should be adopted during minimally invasive surgery for early stage cervical cancer to provide higher survival outcomes.
(Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
