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PR021/#195  Minimally invasive versus open surgery in patients with low risk cervical cancer who underwent simple hysterectomy; an exploratory analysis from the CCTG cx.5/shape trial cx.5/shape trial
  1. Marie Plante1,
  2. Sven Mahner2,
  3. Alexandra Sebastianelli3,
  4. Paul Bessette4,
  5. Eric Lambaudie5,
  6. Frederic Guyon6,
  7. Jurgen Piek7,
  8. Ramon Smolders8,
  9. John Tidy9,
  10. Karin Williamson10,
  11. Lars Hanker11,
  12. Frederic Goffin12,
  13. Irina Tsibulak13,
  14. Brynhildur Eyjolfsdottir14,
  15. Noreen Gleeson15,
  16. Jung-Yun Lee16,
  17. Janice Kwon17,
  18. Sarah Ferguson18,
  19. Dongsheng Tu19 and
  20. Lois Shepherd19
  1. 1Centre Hospitalier Universitaire de Québec, Département D’obstétrique Et Gynécologie, Quebec City, Canada
  2. 2LMU Munich, Munich, Germany
  3. 3CHU de QUebec, Quebec, Canada
  4. 4CHU de Sherbrooke, Sherbrooke, Canada
  5. 5Institut Paoli-Calmettes, Marseilles, France
  6. 6Institut Bergonié, Bordeaux, France
  7. 7Catharina Hospital Eindhoven, Eindhoven, Netherlands
  8. 8Erasmus Medical Center, Department of Gynaecologic Oncology, Rotterdam, Netherlands
  9. 9Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  10. 10NUH.NHS, Nottingham, UK
  11. 11Universitat Zu Lubeck, Lubeck, Germany
  12. 12Chu.ulg.ac, Liege, Belgium
  13. 13Medical University of Innsbruck, Department of Obstetrics and Gynecology, Innsbruck, Austria
  14. 14Oslo University Hospital, Radium Hospital, Department of Gynecologic Oncology, Oslo, Norway
  15. 15St. Vincent University Hospital, Dublin, Ireland
  16. 16Yonsei University College of Medicine, Gynecologic Cancer Center, Seoul, Korea, Republic of
  17. 17University of British Columbia, Vancouver, Canada
  18. 18Princess Margaret cancer centre, Gynecologic Oncology, Toronto, Canada
  19. 19Queens’ University, Kingston, Canada

Abstract

Introduction The LACC demonstrated that minimally invasive radical hysterectomy was associated with poorer outcomes among women with early-stage cervical cancer. It is unknown whether this applies to patients with simple hysterectomy (SH).

Methods Univariate and multivariate Cox models were used to assess association of minimum invasive surgery (MIS) versus open surgery and other variables (age, race, ECOG status, BMI, stage, histologic type and grade, diagnostic procedure, region and time period of enrolment, margin status and lymph vascular space invasion before surgery and on final pathology, and positive nodes, residual disease, and lesions > 2 cm on final pathology) with clinical outcomes, including pelvic and extrapelvic recurrence free survival (PRFS and EPRFS), recurrence free survival (RFS), and overall survival (OS), among patients who underwent SH in SHAPE.

Results With a median follow up of 4.5 years, a total of 12 (4.3%) recurrences were observed in 281 patients having MIS versus 3 (5.3%) in 57 having open surgery SH. Significant difference between patients receiving MIS and open surgery was found in histological type (p=0.005) and the time period of enrolment (p<0.001). Significantly less patients treated by MIS had residual disease in the hysterectomy specimen compared to open surgery (43.1 vs. 57.9%; p=0.04). No statistically significant difference between MIS and open surgery in any clinical outcome was found (PRFS, EPRFS, RFS or OS).

Conclusion/Implications For patients with SH, there was no statistical evidence on the association of MIS with poorer clinical outcomes. Longer follow-up is needed to confirm these results because of small number of events observed.

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