Oncologic effectiveness of nerve-sparing radical hysterectomy in cervical cancer

Antonino Ditto; Giorgio Bogani; Umberto Leone Roberti Maggiore; Fabio Martinelli; Valentina Chiappa; Carlos Lopez; Stefania Perotto; Domenica Lorusso; Francesco Raspagliesi

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자료유형: 학술저널

저자정보: Antonino Ditto (IRCCS National Cancer Institute) Giorgio Bogani (IRCCS National Cancer Institute) Umberto Leone Roberti Maggiore (IRCCS National Cancer Institute) Fabio Martinelli (IRCCS National Cancer Institute) Valentina Chiappa (IRCCS National Cancer Institute) Carlos Lopez (IRCCS National Cancer Institute) Stefania Perotto (IRCCS National Cancer Institute) Domenica Lorusso (IRCCS National Cancer Institute) Francesco Raspagliesi (IRCCS National Cancer Institute)

저널정보: 대한부인종양학회 Journal of Gynecologic Oncology Journal of Gynecologic Oncology Vol.29 No.3

발행연도: 2018.1

수록면: 1 - 10 (10page)

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Objective: Nerve-sparing radical hysterectomy (NSRH) was introduced with the aim to reduce pelvic dysfunctions related to conventional radical hysterectomy (RH). Here, we sought to assess the effectiveness and safety of NSRH in a relatively large number of the patients of cervical cancer (CC) patients undergoing either primary surgery or neoadjuvant chemotherapy (NACT) followed by surgery. Methods: Outcomes of consecutive patients undergoing NSRH and of a historical cohort of patients undergoing conventional RH were retrospectively reviewed. Results: This study included 325 (49.8%) and 327 (50.2%) undergoing NSRH and RH, respectively. Via a multivariable model, nodal status was the only factor predicting for DFS (hazard ratio [HR]=2.09; 95% confidence interval [CI]=1.17–3.73; p=0.01). A trend towards high risk of recurrence was observed for patients affected by locally advanced cervical cancer (LACC) undergoing NACT followed by surgery (HR=2.57; 95% CI=0.95–6.96; p=0.06). Type of surgical procedures (NSRH vs. RH) did not influence risk of recurrence (p=0.47). Similarly, we observed that the execution of NSRH rather than RH had not a detrimental effect on OS (HR=1.19; 95% CI=0.16–9.01; p=0.87). Via multivariable model, no factor directly correlated with OS. No difference in early complication rates was observed between the study groups. Conversely, a significant higher number of late complications was reported in RH versus NSRH groups (p=0.02). Conclusion: Our data suggested that NSRH upholds effectiveness of conventional RH, without increasing recurrence and complication rates but improving pelvic dysfunction rates.

참고문헌 (18)

참고문헌 신청

Ferlay J / 2015 / Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012 / Int J Cancer 136:E359~E386

Raspagliesi F / 2016 / Incorporating 3D laparoscopy for the management of locally advanced cervical cancer: a comparison with open surgery / Tumori 102:393~397

Rob L / 2010 / Nerve-sparing and individually tailored surgery for cervical cancer / Lancet Oncol 11:292~301

Kobayashi T / 1961 / Abdominal radical hysterectomy with pelvic lymphadenectomy for cancer of the cervix / Nanzando

Fujii S / 2008 / Anatomic identification of nerve-sparing radical hysterectomy: a step-by-step procedure / Gynecol Oncol 111:S33~S41

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Antonino Ditto

소속기관 Fondazione IRCCS Istituto Nazionale dei Tumori di Milano

주요연구분야 의약학 > 임상의학 > 산부인과학

논문수 15 이용수 0

Giorgio Bogani

소속기관 Fondazione IRCCS Istituto Nazionale dei Tumori di Milano

주요연구분야 의약학 > 임상의학 > 산부인과학

논문수 21 이용수 4

Umberto Leone Roberti Maggiore

소속기관 Gynecologic Oncology Unit Fondazione IRCCS Istituto Nazionale dei Tumori di Milano Milan Italy

주요연구분야 의약학 > 임상의학 > 산부인과학

논문수 10 이용수 2

Fabio Martinelli