Primary conization overcomes the risk of developing local recurrence following laparoscopic radical hysterectomy in early stage cervical cancer.

Abstract

OBJECTIVE:

To investigate whether primary conization might overcome the risk of local dissemination in patients undergoing laparoscopic radical hysterectomy.

METHODS:

Consecutive data of 262 patients with early stage cervical cancer were retrieved: 88 women had conization followed by radical hysterectomy. A propensity-matched comparison (1:1) was carried out in order to compare laparoscopy and open surgery. Accumulating data highlighted that minimally invasive surgery has been associated with higher recurrence rates and worse overall survival than open surgery in women with early stage cervical cancer.

RESULTS:

Data of 35 paired patients (total 70 patients) were analyzed. No between-group differences in baseline, disease, and pathological variables were observed. Patients undergoing laparoscopy correlated with lower blood loss (50 [range 30-100] vs 150 [range 50-500] mL; P<0.001) and shorter length of stay (3 ± 0.8 vs 5.4 ± 1.4 days; P<0.001) compared to open surgery. One local recurrence was observed per group (P=1.00). Type of surgical approach did not influence site of recurrence (P=1.00) or survival outcomes, in terms of 10-year disease-free (P=0.549, log-rank test) and overall survivals (P=0.615, log-rank test).

CONCLUSIONS:

The data show that primary conization might overcome the risk of local recurrence after laparoscopic radical hysterectomy in early stage cervical cancer. Further prospective evidence is needed.

• Authors: Giorgio Bogani, Antonino Ditto, Valentina Chiappa, Ciro Pinelli, Cristina Sonetto, Francesco Raspagliesi
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 151 Issue 1 Pg. 43-48 (Oct 2020) ISSN: 1879-3479 [Electronic] United States
• PMID: 32511745 (Publication Type: Journal Article)
• Copyright: © 2020 International Federation of Gynecology and Obstetrics.

Topics

• Blood Loss, Surgical
• Case-Control Studies
• Cervix Uteri (surgery)
• Conization
• Disease-Free Survival
• Female
• Humans
• Hysterectomy (methods)
• Italy (epidemiology)
• Laparoscopy
• Length of Stay
• Middle Aged
• Neoplasm Recurrence, Local (epidemiology, prevention & control)
• Retrospective Studies
• Uterine Cervical Neoplasms (mortality, pathology, surgery)