PT  - JOURNAL ARTICLE
AU  - Sabrina A.H.M. van den Tillaart
AU  - Gemma G. Kenter
AU  - Alexander A.W. Peters
AU  - Friedo W. Dekker
AU  - Katja N. Gaarenstroom
AU  - Gertjan J. Fleuren
AU  - J. Baptist M.Z. Trimbos
TI  - Nerve-Sparing Radical Hysterectomy: Local Recurrence Rate, Feasibility, and Safety in Cervical Cancer Patients Stage IA to IIA
AID  - 10.1111/IGC.0b013e318197f675
DP  - 2009 Jan 01
TA  - International Journal of Gynecologic Cancer
PG  - 39--45
VI  - 19
IP  - 1
4099  - http://ijgc.bmj.com/content/19/1/39.short
4100  - http://ijgc.bmj.com/content/19/1/39.full
SO  - Int J Gynecol Cancer2009 Jan 01; 19
AB  - Objective: To clarify the debate about the possible threat of sparing the pelvic autonomic nerves in radical hysterectomy for cervical cancer to radicality, comparative studies of nerve-sparing and conventional surgery are necessary. The aim of his study was to analyze and compare local recurrence rate, feasibility, and safety of nerve-sparing and non-nerve-sparing radical hysterectomy.Methods: In a cohort study with 2 years of follow-up, 246 patients with cervical cancer of stages IA to IIA were analyzed: 124 in the non-nerve-sparing group (1994-1999) and 122 in the group where nerve-sparing was the intention-to-treat (2001-2005). Local recurrence rate, local recurrence-free survival, feasibility, and safety were analyzed and compared.Results: The clinical characteristics of the treatment groups were comparable. Sparing the nerves unilaterally or bilaterally was possible in 80% of cases of the nerve-sparing group. Local recurrence rates in the non-nerve-sparing (4.9%) and nerve-sparing (8.3%) group were not significantly different. Mean local recurrence-free survival within 2 years were 22.7 and 22.0 months, respectively. Univariate and multivariate regression analyses showed that nerve-sparing treatment was not a significant prognostic factor for local recurrence. With respect to perioperative and postoperative parameters, operating time and blood loss were less in the nerve-sparing group and mortality was equal (1 patient); the postoperative course of the nerve-sparing group was similar to the state-of-the-art of conventional radical hysterectomy.Conclusions: On the basis of the results of our study, we consider the nerve-sparing technique for cervical cancer stages IA to IIA feasible and safe.