scholarly journals SHOULD WE REALLY ABANDON MINIMALLY INVASIVE SURGERY IN EARLY-STAGE CERVICAL CANCER? ONCOLOGICAL RESULTS OF LAPAROSCOPICALLY ASSISTED RADICAL VAGINAL HYSTERECTOMY

2020 ◽  
Author(s):  
Ariel Gustavo Glickman
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Vaginal Hysterectomy ◽  
Early Stage ◽  
Early Stage Cervical Cancer ◽  
Oncological Results

scholarly journals Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery?

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 846
Author(s):  
Aureli Torné ◽  
Jaume Pahisa ◽  
Jaume Ordi ◽  
Pere Fusté ◽  
Berta Díaz-Feijóo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Survival Rates ◽  
Early Stage Cervical Cancer ◽  
Oncological Results ◽  
Disease Free

Background: Recent evidence indicates that some minimally invasive surgery approaches, such as laparoscopic and robotic-assisted radical hysterectomy, offer lower survival rates to patients with early-stage cervical cancer than open radical hysterectomy. We evaluated the oncological results of a different minimally invasive surgery approach, that of laparoscopically assisted radical vaginal hysterectomy (LARVH) in this setting. Methods: From January 2001 to December 2018, patients with early-stage cervical cancer were treated by LARVH. Colpotomy and initial closure of the vagina were performed following the Schauta operation, avoiding manipulation of the tumor. Laparoscopic sentinel lymph node (SLN) biopsy was performed in all cases. Women treated between 2001 and 2011 also underwent pelvic lymphadenectomy. Results: There were 115 patients included. Intraoperative complications occurred in nine patients (7.8%). After a median follow-up of 87.8 months (range 1–216), seven women (6%) presented recurrence. Four women died (mortality rate 3.4%). The 3- and 4.5-year disease-free survival rates were 96.7% and 93.5%, respectively, and the overall survival was 97.8% and 94.8%, respectively. Conclusion: LARVH offers excellent disease-free and overall survival in women with early-stage cervical cancer and can be considered as an adequate minimally invasive surgery alternative to open radical hysterectomy.

scholarly journals The Surgeon’s Proficiency Affected Survival Outcomes of Minimally Invasive Surgery for Early-Stage Cervical Cancer: A Retrospective Study of 851 Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Ying Yang ◽  
Yue Huang ◽  
Zhengyu Li
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Open Surgery ◽  
Early Stage ◽  
Disease Free Survival ◽  
Survival Outcomes ◽  
Surgery Group ◽  
Early Stage Cervical Cancer

PurposeTo compare the clinical outcomes of patients with early-stage cervical cancer who underwent minimally invasive surgery (MIS) by surgeons in different phases and evaluate whether the proficiency of surgeons affects the survival outcomes.Materials and MethodsA total of 851 patients with early-stage cervical cancer who underwent radical hysterectomy between January 2008 and June 2018 (every year from January to June) at a tertiary hospital were retrospectively analyzed. We categorized patients into four phases according to their sequence (phase one, 1-10 cases; phase two: 11-20 cases; phase three: 21-30 cases; phase four: > 30 cases). Demographics and clinical and pathological data were collected and analyzed.ResultsThere were no statistical differences between the open surgery and MIS groups regarding three- and five-year overall survival (OS) and disease-free survival (DFS). The OS and DFS of patients in the MIS group in phase one were significantly lower than those in later phases and those in the open surgery group after adjustment (OS, P = 0.009; HR, 2.896; 95%CI, 1.303-6.435; DFS, P = 0.009; HR, 2.712; 95%CI, 1.289-5.706). Survival outcomes were not statistically significant when comparing different surgeons.ConclusionThe phase one cases of MIS had lower OS and DFS than those in later phases and those in the open surgery group. Thus, we suggest that the proficiency of surgeons is associated with survival outcomes of MIS. Favorable outcomes can be obtained after a certain number of MIS cases.

scholarly journals Trachelectomy for reproductive-aged women with early-stage cervical cancer: minimally invasive surgery versus laparotomy

2019 ◽  
Vol 220 (5) ◽  
pp. 469.e1-469.e13 ◽  
Author(s):  
Koji Matsuo ◽  
Ling Chen ◽  
Rachel S. Mandelbaum ◽  
Alexander Melamed ◽  
Lynda D. Roman ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Early Stage ◽  
Early Stage Cervical Cancer ◽  
Reproductive Aged Women

scholarly journals Robotic radical hysterectomy for early-stage cervical cancer: A systematic literature review

2021 ◽  
Vol 2 (2) ◽  
pp. 33-42
Author(s):  
Gun Oh Chong
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Radical Hysterectomy ◽  
Open Surgery ◽  
Early Stage ◽  
Laparoscopic Approach ◽  
Robotic Radical Hysterectomy ◽  
Early Stage Cervical Cancer

Robotic technology has recently come into widespread use to overcome the limitations of laparoscopic radical hysterectomy in the treatment of early-stage cervical cancer. Most comparative studies showed that blood loss and hospital stays for patients undergoing minimally invasive surgery, including robotic procedures, were superior compared to open surgery. Moreover, the survival outcomes of robotic radical hysterectomy were not inferior to open radical hysterectomy. Unexpectedly, the Laparoscopic Approach to Cervical Cancer (LACC) trial, a randomized, open-label, noninferiority study that compared minimally invasive radical hysterectomy with open radical hysterectomy, revealed that minimally invasive surgery was associated with a higher risk of recurrence and death compared with open surgery. Strict guidelines for robotic radical hysterectomy for the treatment of early-stage cervical cancer should be established in accordance with objective Korean data. In addition, it is recommended that further studies should be performed on how to avoid the use of uterine manipulators and the dissemination of cancer cells by ensuring a more effective vaginal closure using a standardized approach.

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