Can laparoscopic radical hysterectomy be a standard surgical modality in stage IA2-IIA cervical cancer?

Jin-Hwa Hong, Joong Sub Choi, Jung Hun Lee, Jeong Min Eom, Jung Hwa Ko, Jong Woon Bae, Seon Hye Park

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objectives: To determine if laparoscopic radical hysterectomy (LRH) can be substituted for radical abdominal hysterectomy for women with International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIA cervical cancer. Methods: We retrospectively reviewed the medical records of cervical cancer patients who underwent LRH with laparoscopic pelvic lymphadenectomy (LPL) and/or laparoscopic para-aortic lymphadenectomy (LPAL) from March 2003 to December 2011. Results: Of 118 enrolled patients, six were in FIGO stage IA2, 66 were in IB1, 41 were in IB2, one was in IIA1, and four were in IIA2. The median operating time, perioperative hemoglobin change, the number of harvested pelvic and para-aortic lymph nodes were 270 min (range, 120-495), 1.7 g/dL (range, 0.1-5), 26 (range, 9-55), and 7 (range, 1-39), respectively. There was no unplanned conversion to laparotomy. Intra- and postoperative complications occurred in 16 (13.5%) and 8 (6.7%) patients, respectively. In a median follow-up of 31 months (range, 1-89), 5-year recurrence-free and overall survival rates were 90% and 89%, respectively. Univariate analysis showed that cervical stromal invasion (P = 0.023) and lymph node metastasis (P = 0.018) affected survival rate. Cox-proportional hazards regression analysis showed that lymph node metastasis was the only independent factor for poor prognosis (hazard ratio = 7.0, P = 0.022). Conclusions: LRH with LPL and/or LPAL in women with stage IA2-IIA cervical cancer is safe and feasible in terms of survival and morbidity. Our data suggest the need for larger prospective trials which could support this approach as a new standard of care for stage IA2-IIA cervical cancer.

Original languageEnglish
Pages (from-to)102-106
Number of pages5
JournalGynecologic Oncology
Volume127
Issue number1
DOIs
Publication statusPublished - 2012 Oct 1

Fingerprint

Lymph Node Excision
Hysterectomy
Uterine Cervical Neoplasms
Lymph Nodes
Gynecology
Obstetrics
Survival Rate
Neoplasm Metastasis
Intraoperative Complications
Standard of Care
Laparotomy
Medical Records
Hemoglobins
Regression Analysis
Morbidity
Recurrence
Survival

Keywords

  • Cervical cancer
  • Laparoscopy
  • Radical hysterectomy
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

Cite this

Can laparoscopic radical hysterectomy be a standard surgical modality in stage IA2-IIA cervical cancer? / Hong, Jin-Hwa; Choi, Joong Sub; Lee, Jung Hun; Eom, Jeong Min; Ko, Jung Hwa; Bae, Jong Woon; Park, Seon Hye.

In: Gynecologic Oncology, Vol. 127, No. 1, 01.10.2012, p. 102-106.

Research output: Contribution to journalArticle

Hong, Jin-Hwa ; Choi, Joong Sub ; Lee, Jung Hun ; Eom, Jeong Min ; Ko, Jung Hwa ; Bae, Jong Woon ; Park, Seon Hye. / Can laparoscopic radical hysterectomy be a standard surgical modality in stage IA2-IIA cervical cancer?. In: Gynecologic Oncology. 2012 ; Vol. 127, No. 1. pp. 102-106.
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abstract = "Objectives: To determine if laparoscopic radical hysterectomy (LRH) can be substituted for radical abdominal hysterectomy for women with International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIA cervical cancer. Methods: We retrospectively reviewed the medical records of cervical cancer patients who underwent LRH with laparoscopic pelvic lymphadenectomy (LPL) and/or laparoscopic para-aortic lymphadenectomy (LPAL) from March 2003 to December 2011. Results: Of 118 enrolled patients, six were in FIGO stage IA2, 66 were in IB1, 41 were in IB2, one was in IIA1, and four were in IIA2. The median operating time, perioperative hemoglobin change, the number of harvested pelvic and para-aortic lymph nodes were 270 min (range, 120-495), 1.7 g/dL (range, 0.1-5), 26 (range, 9-55), and 7 (range, 1-39), respectively. There was no unplanned conversion to laparotomy. Intra- and postoperative complications occurred in 16 (13.5{\%}) and 8 (6.7{\%}) patients, respectively. In a median follow-up of 31 months (range, 1-89), 5-year recurrence-free and overall survival rates were 90{\%} and 89{\%}, respectively. Univariate analysis showed that cervical stromal invasion (P = 0.023) and lymph node metastasis (P = 0.018) affected survival rate. Cox-proportional hazards regression analysis showed that lymph node metastasis was the only independent factor for poor prognosis (hazard ratio = 7.0, P = 0.022). Conclusions: LRH with LPL and/or LPAL in women with stage IA2-IIA cervical cancer is safe and feasible in terms of survival and morbidity. Our data suggest the need for larger prospective trials which could support this approach as a new standard of care for stage IA2-IIA cervical cancer.",
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T1 - Can laparoscopic radical hysterectomy be a standard surgical modality in stage IA2-IIA cervical cancer?

AU - Hong, Jin-Hwa

AU - Choi, Joong Sub

AU - Lee, Jung Hun

AU - Eom, Jeong Min

AU - Ko, Jung Hwa

AU - Bae, Jong Woon

AU - Park, Seon Hye

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N2 - Objectives: To determine if laparoscopic radical hysterectomy (LRH) can be substituted for radical abdominal hysterectomy for women with International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIA cervical cancer. Methods: We retrospectively reviewed the medical records of cervical cancer patients who underwent LRH with laparoscopic pelvic lymphadenectomy (LPL) and/or laparoscopic para-aortic lymphadenectomy (LPAL) from March 2003 to December 2011. Results: Of 118 enrolled patients, six were in FIGO stage IA2, 66 were in IB1, 41 were in IB2, one was in IIA1, and four were in IIA2. The median operating time, perioperative hemoglobin change, the number of harvested pelvic and para-aortic lymph nodes were 270 min (range, 120-495), 1.7 g/dL (range, 0.1-5), 26 (range, 9-55), and 7 (range, 1-39), respectively. There was no unplanned conversion to laparotomy. Intra- and postoperative complications occurred in 16 (13.5%) and 8 (6.7%) patients, respectively. In a median follow-up of 31 months (range, 1-89), 5-year recurrence-free and overall survival rates were 90% and 89%, respectively. Univariate analysis showed that cervical stromal invasion (P = 0.023) and lymph node metastasis (P = 0.018) affected survival rate. Cox-proportional hazards regression analysis showed that lymph node metastasis was the only independent factor for poor prognosis (hazard ratio = 7.0, P = 0.022). Conclusions: LRH with LPL and/or LPAL in women with stage IA2-IIA cervical cancer is safe and feasible in terms of survival and morbidity. Our data suggest the need for larger prospective trials which could support this approach as a new standard of care for stage IA2-IIA cervical cancer.

AB - Objectives: To determine if laparoscopic radical hysterectomy (LRH) can be substituted for radical abdominal hysterectomy for women with International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IIA cervical cancer. Methods: We retrospectively reviewed the medical records of cervical cancer patients who underwent LRH with laparoscopic pelvic lymphadenectomy (LPL) and/or laparoscopic para-aortic lymphadenectomy (LPAL) from March 2003 to December 2011. Results: Of 118 enrolled patients, six were in FIGO stage IA2, 66 were in IB1, 41 were in IB2, one was in IIA1, and four were in IIA2. The median operating time, perioperative hemoglobin change, the number of harvested pelvic and para-aortic lymph nodes were 270 min (range, 120-495), 1.7 g/dL (range, 0.1-5), 26 (range, 9-55), and 7 (range, 1-39), respectively. There was no unplanned conversion to laparotomy. Intra- and postoperative complications occurred in 16 (13.5%) and 8 (6.7%) patients, respectively. In a median follow-up of 31 months (range, 1-89), 5-year recurrence-free and overall survival rates were 90% and 89%, respectively. Univariate analysis showed that cervical stromal invasion (P = 0.023) and lymph node metastasis (P = 0.018) affected survival rate. Cox-proportional hazards regression analysis showed that lymph node metastasis was the only independent factor for poor prognosis (hazard ratio = 7.0, P = 0.022). Conclusions: LRH with LPL and/or LPAL in women with stage IA2-IIA cervical cancer is safe and feasible in terms of survival and morbidity. Our data suggest the need for larger prospective trials which could support this approach as a new standard of care for stage IA2-IIA cervical cancer.

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KW - Radical hysterectomy

KW - Survival

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