TY - JOUR T1 - SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 1269 LP - 1277 DO - 10.1136/ijgc-2020-001506 VL - 30 IS - 9 AU - Luis Chiva AU - Vanna Zanagnolo AU - Denis Querleu AU - Nerea Martin-Calvo AU - Juan Arévalo-Serrano AU - Mihai Emil Căpîlna AU - Anna Fagotti AU - Ali Kucukmetin AU - Constantijne Mom AU - Galina Chakalova AU - Shamistan Aliyev AU - Mario Malzoni AU - Fabrice Narducci AU - Octavio Arencibia AU - Francesco Raspagliesi AU - Tayfun Toptas AU - David Cibula AU - Dilyara Kaidarova AU - Mehmet Mutlu Meydanli AU - Mariana Tavares AU - Dmytro Golub AU - Anna Myriam Perrone AU - Robert Poka AU - Dimitrios Tsolakidis AU - Goran Vujić AU - Marcin A Jedryka AU - Petra L M Zusterzeel AU - Jogchum Jan Beltman AU - Frederic Goffin AU - Dimitrios Haidopoulos AU - Herman Haller AU - Robert Jach AU - Iryna Yezhova AU - Igor Berlev AU - Margarida Bernardino AU - Rasiah Bharathan AU - Maximilian Lanner AU - Minna M Maenpaa AU - Vladyslav Sukhin AU - Jean-Guillaume Feron AU - Robert Fruscio AU - Kersti Kukk AU - Jordi Ponce AU - Jose Angel Minguez AU - Daniel Vázquez-Vicente AU - Teresa Castellanos AU - Enrique Chacon AU - Juan Luis Alcazar A2 - , Y1 - 2020/09/01 UR - http://ijgc.bmj.com/content/30/9/1269.abstract N2 - Background Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse.Methods We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group.Results Mean age was 48.3 years (range; 23–83) while the mean BMI was 25.7 kg/m2 (range; 15–49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07; 95% CI, 1.35 to 3.15; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76; 95% CI, 1.75 to 4.33; P<0.001) and those without the use of a uterine manipulator had similar disease-free-survival to the open surgery group (HR, 1.58; 95% CI, 0.79 to 3.15; P=0.20). Moreover, patients that underwent minimally invasive surgery with protective vaginal closure had similar rates of relapse to those who underwent open surgery (HR, 0.63; 95% CI, 0.15 to 2.59; P<0.52).Conclusions Minimally invasive surgery in cervical cancer increased the risk of relapse and death compared with open surgery. In this study, avoiding the uterine manipulator and using maneuvers to avoid tumor spread at the time of colpotomy in minimally invasive surgery was associated with similar outcomes to open surgery. Further prospective studies are warranted. ER -