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  • Comparison of Different Surgical Approaches for Stage IB1 Cervical Cancer Patients: A Multi-institution Study and a Review of the Literature

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Cervical Cancer
Comparison of Different Surgical Approaches for Stage IB1 Cervical Cancer Patients: A Multi-institution Study and a Review of the Literature
  1. Giacomo Corrado, PhD, MD*,
  2. Enrico Vizza, MD, PhD†,
  3. Francesco Legge, MD‡,
  4. Luigi Pedone Anchora, MD*,
  5. Isabella Sperduti, MD§,
  6. Anna Fagotti, MD, PhD*,
  7. Emanuela Mancini, MD†,
  8. Valerio Gallotta, MD*,
  9. Ashanti Zampa†,
  10. Benito Chiofalo, MD† and
  11. Giovanni Scambia, MD, PhD*
  1. * Gynecologic Oncology Unit, Department of Health of Women and Children, Catholic University of Sacred Heart; and
  2. † Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, “Regina Elena” National Cancer Institute, Rome;
  3. ‡ Division of Gynecology, Department of Obstetrics and Gynecology, “F. Miulli” General Hospital, Bari; and
  4. § Scientific Direction, “Regina Elena” National Cancer Institute, Rome, Italy.
  1. Address correspondence and reprint requests to Giacomo Corrado, MD, PhD, Gynecologic Oncology Unit, Department of Health of Woman and Child, Catholic University of the Sacred Heart, L.go A. Gemelli 8, 00168, Rome, Italy. E-mail: giacomo.corrado{at}alice.it.

Abstract

Objective The aim of this retrospective study was to assess the surgical and oncological outcome of 3 different surgical approaches (laparotomy, laparoscopy, and robotic surgery) in the treatment of early-stage cervical cancer International Federation of Gynecology and Obstetrics (FIGO) stage IB1.

Methods All patients with a histologically confirmed diagnosis of early-stage cervical cancer, FIGO stage IB1, who underwent abdominal radical hysterectomy (ARH), laparoscopic radical hysterectomy, or robotic radical hysterectomy with or without pelvic and aortic lymphadenectomy were included in the study. A review of the literature was conducted.

Results Three hundred forty-one patients, between January 2001 and December 2016, were included in this study: 101 patients were submitted to ARH, 152 to laparoscopic radical hysterectomy, and 88 to robotic radical hysterectomy. In 97% and 11.5% of cases, bilateral pelvic and aortic lymph node dissections were performed, respectively. The 3 groups were similar in regard to clinical characteristics. Compared with ARH, the minimally invasive surgery group was safer in terms of estimated blood loss, transfusion rates, and hospital stay. Above all, robotic surgery was equivalent to laparoscopy in terms of intraoperative and postoperative complications, hospital stay, conversions, and reintervention. On the other hand, robotic surgery had better outcomes compared with laparoscopy in terms of transfusion rates and was equivalent to abdominal surgery and laparoscopy in regard to oncological outcomes.

Conclusions Our study confirmed that minimally invasive surgery (laparoscopy or robotics) was as adequate and effective as abdominal surgery in terms of surgical and oncological outcomes in the surgical treatment of EEC FIGO stage IB1.

  • Abdominal radical hysterectomy
  • Early-stage cervical cancer
  • Minimally invasive radical hysterectomy

https://doi.org/10.1097/IGC.0000000000001254

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    Footnotes

    • The authors declare no conflicts of interest.