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Plenary Session 1: Best Oral Communications – Cervical Cancer
SENTIX – Sentinel lymph node in patients with cervical cancer: time to voiding recovery after surgery (CEEGOG-CX01; ENGOT-CX2; NCT02494063)
  1. I Zapardiel1,
  2. R Kocian2,
  3. C Köhler3,
  4. J Klat4,
  5. A Germanova2,
  6. A Jacob3,
  7. S Bajsova4,
  8. G Böhmer3,
  9. L Lay5,
  10. A Torne6,
  11. P Havelka7,
  12. B Kipp8,
  13. G Szewczyk9,
  14. R Toth10,
  15. J Staringer11,
  16. FJ De Santiago12,
  17. PJ Coronado13,
  18. R Poka14,
  19. R Laky15,
  20. M Luyckx16,
  21. M Fastrez17,
  22. L Dusek18,
  23. A Hernandez1 and
  24. D Cibula2
  1. 1Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain
  2. 2Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital, CEEGOG, Prague, Czech Republic
  3. 3Department of Special Operative and Oncologic Gynaecology, Asklepios-Clinic Hamburg, Hamburg, Germany
  4. 4Department of Obstetrics and Gynecology, University Hospital Ostrava, Ostrava Poruba, Czech Republic
  5. 5Departament of Gynecology, Institute of Oncology Angel H Roffo University of Buenos Aires, Buenos Aires, Argentina
  6. 6Unit of Gynecological Oncology, Institute Clinic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic of Barcelona, Barcelona, Spain
  7. 7Department of Obstetrics and Gynaecology, Bata Hospital Zlin, CEEGOG, Zlin, Czech Republic
  8. 8Department of Obstetrics and Gynecology, Cantonal Hospital of Lucerne, Lucerne, Switzerland
  9. 9Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland
  10. 10Oncology Institute of East Slovakia, Košice, Slovakia
  11. 11Department of Gynecology and Obstetrics, Hospital Español de Buenos Aires, Buenos Aires, Argentina
  12. 12Gynecology, MD Anderson Cancer Center
  13. 13Departamento de Obstetricia y Ginecología, Hospital Clínico San Carlos, Madrid, Spain
  14. 14Institute of Obstetrics and Gynaecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
  15. 15Gynecology, Medical University of Graz, Graz, Austria
  16. 16Department of Gynecology, Université catholique de Louvain, Cliniques Universitaires St Luc
  17. 17Department of Obstetrics and Gynaecology, St Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
  18. 18Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic

Abstract

Introduction/Background Despite the use of nerve-sparing technique, bladder dysfunction remains the leading morbidity associated with parametrectomy (radical hysterectomy or trachelectomy). Our aim was to analyze the time to postoperative voiding recovery and the factors influencing it in the SENTIX trial cohort, in whom different types of surgical approach and parametrectomy was used.

Methodology The SENTIX trial is a prospective cohort international study on sentinel lymph node biopsy without pelvic lymphadenectomy in patients with early-stage cervical cancer (≤4 cm or ≤2cm in fertility sparing). It entails 46 sites from 18 countries. Ad hoc analysis of data from the SENTIX trial was performed to assess factors influencing voiding recovery, which was defined as the number of days from surgery to bladder catheter or epicystostomy removal with post-voiding urine residuum <50 mL.

Result The characteristics of the cohort of 372 patients are shown in table 1. Median (range) voiding recovery time was 3 (0–21) days; it was <7 days in 288 (78.5%) patients and <1 month in 357 (97.3%). Among 10 (2.7%) patients with recovery >1 month, only 1 case (80 days) was not associated with any severe intraoperative complication (6 cases) or adjuvant radiotherapy (3 cases). Tumor size >2 cm, open surgery, and a more extensive type of parametrectomy significantly influenced voiding recovery (figure 1). In multivariate analysis, only previous pregnancy and type of parametrectomy were significant (table 2).

Abstract – Figure 1
Abstract – Figure 1

Kaplan - Meier curve for time to voiding recovery according to type of parametrectomy

Abstract – Table 1
Abstract – Table 1

Main characteristics of patients (N=372)

View this table:
Abstract – Table 2

Predictors of voiding recovery >7 days: multivariate analysis

Conclusion Voiding recovery time is directly related to the extent of parametrectomy. It is, however, temporary and almost all patients recover within 1 month, even after a more radical procedure (C2). The higher risk associated with laparotomy reflects a tendency to be more radical with open surgery.

Disclosure This work was supported by a grant from the Czech Research Council (No 16-31643A). There are no conflicts of interest.

http://dx.doi.org/10.1136/ijgc-2019-ESGO.4

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