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EPV063/#357 The impact of surgical approach in cases with no residual disease on hysterectomy specimen: a 4C (Canadian cervical cancer collaborative) working group study
  1. C Aubrey1,
  2. G Pond2,
  3. L Helpman3,
  4. D Vicus4,
  5. L Elit5,
  6. M Plante6,
  7. S Lau7,
  8. J Kwon8,
  9. A Altman9,
  10. K Willows10,
  11. T Feigenberg11,
  12. J Sabourin12,
  13. V Samouelian13,
  14. N Cockburn5,
  15. S Piedimonte14,
  16. L-A Teo-Fortin6,
  17. SR Kim14,
  18. N Sadeq10,
  19. S Shamiya12 and
  20. G Nelson1
  1. 1University of Calgary, Department of Oncology, Division of Gynecologic Oncology, Calgary, Canada
  2. 2McMaster University, Juravinski Cancer Center, Hamilton Health Sciences, Oncology, Hamilton, Canada
  3. 3Juravinski Cancer Center, Gynecologic Oncology, Hamilton, Canada
  4. 4Sunnybrook Health Sciences Centre, Gynecologic Oncology, Toronto, Canada
  5. 5McMaster University, Juravinski Cancer Center, Hamilton Health Sciences, Gynecologic Oncology, Hamilton, Canada
  6. 6Hotel Dieu de Quebec, Gynecologic Oncology, Quebec, Canada
  7. 7McGill University, Jewish General Hospital, Gynecologic Oncology, Montreal, Canada
  8. 8Vancouver General Hospital, Gynecologic Oncology, Vancouver, Canada
  9. 9University of Manitoba, Gynecologic Oncology, Winnipeg, Canada
  10. 10Dalhousie University, Gynecologic Oncology, Halifax, Canada
  11. 11Trillium Health Partners, Gynecologic Oncology, Mississauga, Canada
  12. 12University of Alberta, Gynecologic Oncology, Edmonton, Canada
  13. 13Centre Hospitalier de l’Université de Montréal, Gynecologic Oncology, Montreal, Canada
  14. 14University of Toronto, Gynecologic Oncology, Toronto, Canada


Objectives The adverse effect of laparoscopic/robotic surgery in cervical cancer has been established, however the exact patient population that this applies to has not been fully elucidated. Our objective was to characterize the impact of surgical approach on outcomes in cases of no residual cervical cancer on hysterectomy specimen.

Methods Retrospective cohort study of cases of surgically treated cervical cancer at 10 Canadian institutions from 2007–2019. Cases with no residual disease on hysterectomy specimen were included and subdivided according to: minimally invasive (MIS), abdominal (AH) or combined vaginal-laparoscopic hysterectomy (CVLH). 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.

Results Within the total cohort, 187/1070 (17.5%) had no residual disease on hysterectomy specimen. The distribution according to surgical approach was: 94 MIS, 78 AH, and 15 CVLH. The majority of cases undergoing MIS and AH were stage IB (51% and 60%), and underwent a radical hysterectomy (91% and 67%), whereas of CVLH patients, the majority were stage IA (93%) and underwent a simple hysterectomy (73%). There were no significant differences in RFS (5-year: MIS 96.0%, AH 90.7%, CVLH 100%, p=0.15) or OS (5-year: MIS 98.4%, AH 93.0%, CVLH 100%, p=0.067), although event-rates were low, and regression analysis was not performed.

Conclusions In this study of impact of surgical approach in cases with no residual cervical cancer on hysterectomy specimen, significant differences in RFS and OS among the surgical subgroups was not found. Further studies are warranted.

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