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Tytuł pozycji:

Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: a multicenter analysis.

Tytuł :
Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: a multicenter analysis.
Autorzy :
Rodriguez J; Department of Gynecologic Oncology, Instituto Nacional de Cancerologia, Bogota, Colombia.; Department of Gynecology and Obstetrics, Section of Gynecologic Oncology, Fundacion Santa Fe de Bogota, Bogota, Colombia.
Rauh-Hain JA; Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.
Saenz J; Department of Gynecologic Oncology, Instituto Nacional de Cancerologia, Bogota, Colombia.
Isla DO; Department of Gynecologic Oncology, Instituto Nacional de Cancerologia, Mexico City, Mexico.
Rendon Pereira GJ; Department of Gynecologic Oncology, Instituto de Cancerologia Las Américas, Medellín, Colombia.
Odetto D; Gynecology Oncology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Martinelli F; Department of Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Villoslada V; Department of Gynecologic Oncology, Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru.
Zapardiel I; Gynecologic Oncology Unit. La Paz University Hospital, La Paz University Hospital-IdiPAZ, Madrid, Spain.
Trujillo LM; Department of Gynecologic Oncology, Instituto Nacional de Cancerologia, Bogota, Colombia.
Perez M; Department of Gynecologic Oncology, Instituto Nacional de Cancerologia, Mexico City, Mexico.
Hernandez M; Department of Gynecologic Oncology, Instituto de Cancerologia Las Américas, Medellín, Colombia.
Saadi JM; Gynecology Oncology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Raspagliesi F; Department of Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Valdivia H; Department of Gynecologic Oncology, Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru.
Siegrist J; Gynecologic Oncology Unit. La Paz University Hospital, La Paz University Hospital-IdiPAZ, Madrid, Spain.
Fu S; Departments of Gynecologic Oncology and Reproductive Medicine and Health Services Research, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.
Hernandez Nava M; Department of Gynecologic Oncology, Instituto Nacional de Cancerologia, Mexico City, Mexico.
Echeverry L; Department of Gynecologic Oncology, Instituto de Cancerologia Las Américas, Medellín, Colombia.
Noll F; Gynecology Oncology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Ditto A; Department of Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Lopez A; Department of Gynecologic Oncology, Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru.
Hernandez A; Gynecologic Oncology Unit. La Paz University Hospital, La Paz University Hospital-IdiPAZ, Madrid, Spain.
Pareja R; Department of Gynecologic Oncology, Instituto Nacional de Cancerologia, Bogota, Colombia .; Gynecologic Oncology, Clinica Astorga, Professor Universidad Pontificia Bolivariana, Medellin, Colombia.
Pokaż więcej
Źródło :
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2021 Jan 27. Date of Electronic Publication: 2021 Jan 27.
Publication Model :
Ahead of Print
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Publication: 2019- : [London] : BMJ
Original Publication: Cambridge, MA, USA : Blackwell Scientific Publications, c1991-
Contributed Indexing :
Keywords: hysterectomy; uterine cervical neoplasms
Entry Date(s) :
Date Created: 20210128 Latest Revision: 20210128
Update Code :
20210210
DOI :
10.1136/ijgc-2020-002086
PMID :
33504547
Czasopismo naukowe
Introduction: Recent evidence has shown adverse oncological outcomes when minimally invasive surgery is used in early-stage cervical cancer. The objective of this study was to compare disease-free survival in patients that had undergone radical hysterectomy and pelvic lymphadenectomy, either by laparoscopy or laparotomy.
Methods: We performed a multicenter, retrospective cohort study of patients with cervical cancer stage IA1 with lymph-vascular invasion, IA2, and IB1 (FIGO 2009 classification), between January 1, 2006 to December 31, 2017, at seven cancer centers from six countries. We included squamous, adenocarcinoma, and adenosquamous histologies. We used an inverse probability of treatment weighting based on propensity score to construct a weighted cohort of women, including predictor variables selected a priori with the possibility of confounding the relationship between the surgical approach and survival. We estimated the HR for all-cause mortality after radical hysterectomy with weighted Cox proportional hazard models.
Results: A total of 1379 patients were included in the final analysis, with 681 (49.4%) operated by laparoscopy and 698 (50.6%) by laparotomy. There were no differences regarding the surgical approach in the rates of positive vaginal margins, deep stromal invasion, and lymphovascular space invasion. Median follow-up was 52.1 months (range, 0.8-201.2) in the laparoscopic group and 52.6 months (range, 0.4-166.6) in the laparotomy group. Women who underwent laparoscopic radical hysterectomy had a lower rate of disease-free survival compared with the laparotomy group (4-year rate, 88.7% vs 93.0%; HR for recurrence or death from cervical cancer 1.64; 95% CI 1.09-2.46; P=0.02). In sensitivity analyzes, after adjustment for adjuvant treatment, radical hysterectomy by laparoscopy compared with laparotomy was associated with increased hazards of recurrence or death from cervical cancer (HR 1.7; 95% CI 1.13 to 2.57; P=0.01) and death for any cause (HR 2.14; 95% CI 1.05-4.37; P=0.03).
Conclusion: In this retrospective multicenter study, laparoscopy was associated with worse disease-free survival, compared to laparotomy.
(© IGCS and ESGO 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

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