Article Text
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.