eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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4/2018
vol. 13
 
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Gynaecology
abstract:
Original paper

Class I hysterectomy in stage Ia2-Ib1 cervical cancer

Long Chen, Wei-Na Zhang, Sheng-Miao Zhang, Yuan Gao, Tian-Hong Zhang, Ping Zhang

Videosurgery Miniinv 2018; 13 (4): 494–500
Online publish date: 2018/06/29
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Introduction
During the last 3 decades, the standard treatment for stage Ia2-Ib1 cervical cancer has been Piver-Rutledge class II or III radical hysterectomy. However, this surgery is associated with a high rate of urologic morbidity.

Aim
To determine the efficacy of class I radical hysterectomy compared with class III radical hysterectomy in terms of morbidity, overall survival, and patterns of relapse in patients with Ia2-Ib1 cervical cancer undergoing primary surgery.

Material and methods
A total of 101 patients with stage Ia2-Ib1 cervical cancer < 2 cm were randomized to class I and class III hysterectomy groups. Clinical, pathologic, and follow-up data were prospectively collected. Univariate analysis was carried out. Of the total patients, 45 were randomized to class I surgery and 56 to class III surgery. No significant differences were observed in terms of pathologic findings or adjuvant treatment (p > 0.05). The morbidity rates were higher after class III surgery.

Results
The difference in recurrence rate between the class I and class III groups was not statistically significant (p > 0.05). The 5-year overall survival rate was 93% and 91%, respectively (p > 0.05). There were no significant differences in terms of recurrence rate or overall survival among patients with stage Ia2-Ib1 cervical cancer < 2 cm who underwent class I or radical (class III) hysterectomy. Morbidity was proportional to the extent of radicality.

Conclusions
These data confirm the need for reducing surgical radicality in the treatment of patients with early cervical cancer, by tailoring the extent of resection according to the extent of disease.

keywords:

cervical cancer, class I hysterectomy, radical hysterectomy

references:
Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin 2011; 61: 69-90.
Ramirez PT, Pareja R, Rendón GJ, et al. Management of low-risk early-stage cervical cancer: should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care? Gynecol Oncol 2014; 132: 254-9.
Hacker NF, Friedlander ML. Cervical cancer. In: Gynecologic Oncology. 5th ed. Berek JS, Hacker NF (eds). Wolters Kluwer, Philadelphia 2010; 341-95.
van Meurs H, Visser O, Buist MR, et al. Frequency of pelvic lymph node metastases and parametrial involvement in stage IA2 cervical cancer: a  population-based study and literature review. Int J Gynecol Cancer 2009; 19: 21-6.
Covens A, Rosen B, Murphy J, et al. How important is removal of the parametrium at surgery for carcinoma of the cervix? Gynecol Oncol 2002; 84: 145-9.
Kinney WK, Hodge DO, Egorshin EV, et al. Identification of a  low-risk subset of patients with stage IB invasive squamous cancer of the cervix possibly suited to less radical surgical treatment. Gynecol Oncol 1995; 57: 3-6.
Schmeler KM, Frumovitz M, Ramirez PT. Conservative management of early stage cervical cancer: is there a  role for less radical surgery? Gynecol Oncol 2011; 120: 321-5.
Frumovitz M, Sun CC, Schover LR, et al. Quality of life and sexual functioning in cervical cancer survivors. J Clini Oncol 2005; 23: 7428-36.
Matsuo K, Mabuchi S, Okazawa M, et al. Utility of risk-weighted surgical-pathological factors in early-stage cervical cancer. Br J Cancer 2013; 108: 1348-57.
Landoni F, Maneo A, Cormio G, et al. Class II versus class III in stage IB-IIA cervical cancer: a  prospective randomized study. Gynecol Oncol 2001; 80: 3-12.
Steed H, Capstick V, Schepansky A, et al. Early cervical cancer and parametrial involvement: is it significant? Gynecol Oncol 2006; 103: 53-7.
Wright JD, Grigsby PW, Brooks R, et al. Utility of parametrectomy for early stage cervical cancer treated with radical hysterectomy. Cancer 2007; 110: 1281-6.
Strnad P, Robova H, Skapa P, et al. A  prospective study of sentinel lymph node status and parametrial involvement in patients with small tumour volume cervical cancer. Gynecol Oncol 2008; 109: 280-4.
Frumovitz M, Sun CC, Schmeler KM, et al. Parametrial involvement in radical hysterectomy specimens for women with early-stage cervical cancer. Obstet Gynecol 2009; 114: 93-9.
Diaz JP, Gemignani ML, Pandit-Taskar N, et al. Sentinel lymph node biopsy in the management of early-stage cervical carcinoma. Gynecol Oncol 2011; 120: 347-52.
Rossetti D, Vitale SG, Tropea A, et al. New procedures for the identification of sentinel lymph node: shaping the horizon of future management in early stage uterine cervical cancer. Updates Surg 2017; 69: 383-8.
Arimoto T, Kawana K, Adachi K, et al. Minimization of curative surgery for treatment of early cervical cancer: a  review. Jpn J Clin Oncol 2015; 45: 611-6.
Landoni F, Maneo A, Zapardiel I, et al. Class I  versus class III radical hysterectomy in stage IB1-IIA cervical cancer. A  prospective randomized study. Eur J Surg Oncol 2012; 38: 203-9.
Stark G. Surgical therapy of stage IB cervix cancer. Geburtshilfe Frauenheilkd 1987; 47: 45-8.
Landoni F, Bocciolone L, Perego P, et al. Cancer of the cervix, FIGO stages IB and IIA: patterns of local growth and paracervical extension. Int J Gynecol Cancer 1995; 5: 329-34.
Sartori E, Fallo L, La Face B, et al. Extended radical hysterectomy in early-stage carcinoma of the uterine cervix: tailoring the radicality. Int J Gynecol Cancer 1995; 5: 143-7.
Valenti G, Vitale SG, Tropea A, et al. Tumor markers of uterine cervical cancer: a  new scenario to guide surgical practice? Updates Surg 2017; 69: 441-9.
Chen L, Zhang WN, Zhang SM, et al. Effect of laparoscopic nerve-sparing radical hysterectomy on bladder function, intestinal function recovery and quality of sexual life in patients with cervical carcinoma. Asian Pac J Cancer Prev 2014; 15: 10971-5.
  
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