Comparison of survival outcomes between laparoscopic and abdominal radical hysterectomy for early-stage cervical cancer: A French multicentric study - 17/01/21

Doi : 10.1016/j.jogoh.2020.102046

François Zaccarini ^a, Anna Santy ^b, Yohann Dabi ^c, Vincent Lavoue ^d, Xavier Carcopino ^e, Sofiane Bendifallah ^a, Amélie Benbara ^f, Pierre Collinet ^g, Geoffroy Canlorbe ^h, Emilie Raimond ⁱ, Olivier Graesslin ⁱ, Lobna Ouldamer ^j, Emile Daraï ^a, Cyrille Huchon ^k, François Golfier ^b, Cyril Touboul ^a,⁎ , Pierre-Adrien Bolze ^b
^a Department of Gynecology and Obstetrics, Tenon University Hospital (AP-HP), Sorbonne University, Institut Universitaire de Cancérologie (IUC), France
^b Lyon 1 University, Department of Gynecological and Oncological Surgery, Obstetrics, University Hospital Lyon Sud, 69495, Pierre Bénite, France
^c Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Faculté de médecine de Créteil UPEC – Paris XII, Créteil, France
^d Department of Gynecologic Surgery, CHU de Rennes, Université de Rennes 1, France
^e Department of Obstetrics and Gynecology, Hopital Nord, APHM, Marseilles, France
^f Department of Obstetrics and Gynecology, Jean-Verdier University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), France
^g Department of Obstetrics and Gynecology, Centre Hospitalier Régional Universitaire, Lille, France
^h Department of Gynaecology and Obstetrics, Pitié Salpetrière University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), France
ⁱ Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
^j Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours, France
^k Department of Gynaecology and Obstetrics, Intercommunal Hospital Centre of Poissy-Saint-Germain-en-Laye, 78103, Poissy, France

^⁎Corresponding author at: Service de Gynécologie Obstétrique, Hôpital Tenon Assistance Publique des Hôpitaux de Paris, 8 rue de la Chine, 75020, Paris, France.Service de Gynécologie ObstétriqueHôpital Tenon Assistance Publique des Hôpitaux de Paris8 rue de la ChineParis75020France

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Abstract

Objectives

A recent randomized controlled trial has reconsidered the use of laparoscopy for treating patients with early-stage cervical cancer with radical hysterectomy (RH). We aimed to evaluate if surgical approach had an impact on surgical and oncological outcomes in these patients in a French setting.

Methods

Data of 1706 patients with cervical cancer treated between 1996 and 2017 were extracted from maintained databases of 9 French University hospitals. Patients, with FIGO stage IA2 to IIB tumors, treated by radical hysterectomy were selected for further analysis. A propensity score matching was used with a ratio of 2:1 in favor of laparoscopic approach was used. The Kaplan Meier method was used to estimate the survival distribution.

Results

34 patients treated with laparotomy were matched with 61 patients treated by minimally invasive surgery (MIS). There was no difference regarding overall survival (91 % vs 81 %, p > 0.05) or disease-free survival (82 % vs 78 %, p > 0.05). There was no difference regarding surgical outcomes with no excess of postoperative complication in patients with MIS. Hospital stay was significantly longer in patients operated on laparotomy.

Conclusion

In our study, there was no evidence of a difference in survival between minimally invasive surgery and laparotomy in patients treated with radical hysterectomy for early-stage cervical cancer.

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Keywords : Cervical cancer, Radical hysterectomy, Laparoscopy, Open surgery, Survival outcomes

Plan

Introduction

Material and methods

Patients and selection criteria

Statistical analysis

Results

Characteristics of the population

Survival outcomes

Intra and post-operative complications

Histopathological results

Discussion

Conclusion

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Vol 50 - N° 2

Article 102046- février 2021 Retour au numéro

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Comparison of survival outcomes between laparoscopic and abdominal radical hysterectomy for early-stage cervical cancer: A French multicentric study - 17/01/21

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