دورية أكاديمية
Minimally invasive radical hysterectomy: an analysis of oncologic outcomes from Hospital Italiano (Argentina).
| العنوان: | Minimally invasive radical hysterectomy: an analysis of oncologic outcomes from Hospital Italiano (Argentina). |
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| المؤلفون: | Odetto D; Department of Gynecologic Oncology, Hospital Italiano de Buenos Aires, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina diego.odetto@hospitalitaliano.org.ar., Puga MC; Department of Clinical Investigation, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Saadi J; Department of Gynecologic Oncology, Hospital Italiano de Buenos Aires, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Noll F; Department of Gynecologic Oncology, Hospital Italiano de Buenos Aires, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Perrotta M; Department of Gynecologic Oncology, Hospital Italiano de Buenos Aires, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. |
| المصدر: | International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2019 Jun; Vol. 29 (5), pp. 863-868. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BMJ Country of Publication: England NLM ID: 9111626 Publication Model: Print Cited Medium: Internet ISSN: 1525-1438 (Electronic) Linking ISSN: 1048891X NLM ISO Abbreviation: Int J Gynecol Cancer Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2019- : [London] : BMJ Original Publication: Cambridge, MA, USA : Blackwell Scientific Publications, c1991- |
| مواضيع طبية MeSH: | Hysterectomy/*statistics & numerical data , Minimally Invasive Surgical Procedures/*statistics & numerical data , Uterine Cervical Neoplasms/*surgery, Adult ; Aged ; Argentina/epidemiology ; Cohort Studies ; Disease-Free Survival ; Female ; Humans ; Hysterectomy/methods ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging ; Retrospective Studies ; Treatment Outcome ; Uterine Cervical Neoplasms/epidemiology ; Uterine Cervical Neoplasms/pathology |
| مستخلص: | Background: The 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. Objectives: To evaluate surgical and oncological outcome of laparoscopic radical hysterectomy performed at Hospital Italiano in Buenos Aires, Argentina. Methods: This 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. Results: A 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%). Conclusion: The 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. Competing Interests: Competing interests: None declared. (© IGCS and ESGO 2019. No commercial re-use. See rights and permissions. Published by BMJ.) |
| فهرسة مساهمة: | Keywords: cervical cancer; laparoscopy; minimally invasive surgery; radical hysterectomy |
| تواريخ الأحداث: | Date Created: 20190604 Date Completed: 20200203 Latest Revision: 20200203 |
| رمز التحديث: | 20240513 |
| DOI: | 10.1136/ijgc-2019-000323 |
| PMID: | 31155517 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1525-1438 |
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| DOI: | 10.1136/ijgc-2019-000323 |