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Oncologic Outcomes of Surgically Treated Cervical Cancer with No Residual Disease on Hysterectomy Specimen: A 4C (Canadian Cervical Cancer Collaborative) Working Group Study

Authors :
Christa Aubrey
Gregory R. Pond
Limor Helpman
Danielle Vicus
Laurie Elit
Marie Plante
Susie Lau
Janice S. Kwon
Alon D. Altman
Karla Willows
Tomer Feigenberg
Jeanelle Sabourin
Vanessa Samouelian
Laurence Bernard
Norah Cockburn
Nora-Beth Saunders
Sabrina Piedimonte
Ly-Ann Teo-Fortin
Soyoun Rachel Kim
Noor Sadeq
Ji-Hyun Jang
Sarah Shamiya
Gregg Nelson
Source :
Current Oncology, Volume 30, Issue 2, Pages: 1977-1985
Publication Year :
2023
Publisher :
Multidisciplinary Digital Publishing Institute, 2023.

Abstract

Minimally invasive surgery for the treatment of macroscopic cervical cancer leads to worse oncologic outcomes than with open surgery. Preoperative conization may mitigate the risk of surgical approach. Our objective was to describe the oncologic outcomes in cases of cervical cancer initially treated with conization, and subsequently found to have no residual cervical cancer after hysterectomy performed via open and minimally invasive approaches. This was a retrospective cohort study of surgically treated cervical cancer at 11 Canadian institutions from 2007 to 2017. Cases initially treated with cervical conization and subsequent hysterectomy, with no residual disease on hysterectomy specimen were included. They were subdivided according to minimally invasive (laparoscopic/robotic (MIS) or laparoscopically assisted vaginal/vaginal hysterectomy (LVH)), or abdominal (AH). Recurrence free survival (RFS) and overall survival (OS) were estimated using Kaplan–Meier analysis. Chi-square and log-rank tests were used to compare between cohorts. Within the total cohort, 238/1696 (14%) had no residual disease on hysterectomy specimen (122 MIS, 103 AH, and 13 VLH). The majority of cases in the cohort were FIGO 2018 stage IB1 (43.7%) and underwent a radical hysterectomy (81.9%). There was no statistical difference between stage, histology, and radical vs simple hysterectomy between the abdominal and minimally invasive groups. There were no significant differences in RFS (5-year: MIS/LVH 97.7%, AH 95.8%, p = 0.23) or OS (5-year: MIS/VLH 98.9%, AH 97.4%, p = 0.10), although event-rates were low. There were only two recurrences. In this large study including only patients with no residual cervical cancer on hysterectomy specimen, no significant differences in survival were seen by surgical approach. This may be due to the small number of events or due to no actual difference between the groups. Further studies are warranted.

Details

Language :
English
ISSN :
17187729
Database :
OpenAIRE
Journal :
Current Oncology
Accession number :
edsair.doi.dedup.....24979658c7c04c3fa87a8fc07c2838e4
Full Text :
https://doi.org/10.3390/curroncol30020153