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01-02-2012 | Gynecologic Oncology

Comparison of Survival and Adverse Events between Women with Stage IB1 and Stage IB2 Cervical Cancer Treated by Laparoscopic Radical Vaginal Hysterectomy

Authors: Jin Hwa Hong, MD, Joong Sub Choi, MD, Jung Hun Lee, MD, Chang Eop Son, MD, Seung Wook Jeon, MD, Jong Woon Bae, MD, Jeong Min Eom, MD

Published in: Annals of Surgical Oncology | Issue 2/2012

Abstract

Purpose

The goal of this study was to evaluate the operative feasibility and survival for patients with stage IB2 cervical cancer who undergo laparoscopic radical vaginal hysterectomy (LRVH) compared with those with stage IB1 cervical cancer.

Methods

We identified 90 patients who were eligible to participate in the study through retrospective analysis of medical records from March 2003 to June 2010. Patients with stage IB1 cervical cancer were divided into two groups by a cutoff value of 2 cm for tumor size. Data regarding surgicopathologic risk factors, surgical outcomes, and survival rates were compared among three groups (two with stage IB1 and one with stage IB2).

Results

The tumor size was ≤2 cm in 27 patients, 2–4 cm in 30, and >4 cm in 33. The number of intermediate and high-risk factors was significantly lower in patients with stage IB1 cervical cancer (≤2 cm) than in those with stage IB2. Surgical outcomes (mean operating time, estimated blood loss, number of harvested lymph nodes, and sites of metastatic lymph nodes) did not show any significant difference among the three groups. The rates of intraoperative complications also did not differ among the three groups (P = 0.833). The estimated 5-year recurrence-free and overall survival rates were not significantly different among the three groups (P = 0.253 and 0.525, respectively).

Conclusions

LRVH for stage IB2 cervical cancer can be performed with similar safety and survival rates compared to stage IB1 cervical cancer. Overall, LRVH is feasible for the treatment of stage IB2 cervical cancer.

Creasman WT. New gynecologic cancer staging. Gynecol Oncol. 1995;58(2):157–8.PubMedCrossRef

Kim HS, Song YS. International Federation in Gynecology and Obstetrics (FIGO) staging system revised. What should be considered critically for gynecologic cancer? J Gynecol Oncol. 2009;20(3):135–6.PubMedCrossRef

Rutledge TL, Kamelle SA, Tillmanns TD, Gould NS, Wright JD, Cohn DE, et al. A comparison of stage IB1 and IB2 cervical cancers treated with radical hysterectomy. Is size the real difference? Gynecol Oncol. 2004;95:70–6.PubMedCrossRef

Horn LC, Fischer U, Raptis G, Bilek K, Hentschel B. Tumor size is of prognostic value in surgically treated FIGO stage II cervical cancer. Gynecol Oncol. 2007;107:310–5.PubMedCrossRef

Finan MA, DeCesare S, Fiorica JV, Chambers R, Hoffman MS, Kline RC, et al. Radical hysterectomy for stage IB1 vs IB2 carcinoma of the cervix: does the new staging system predict morbidity and survival? Gynecol Oncol. 1996;62:139–47.PubMedCrossRef

Wagenaar HC, Trimbos JB, Postema S, Anastasopoulou A, van der Geest RJ, Reiber JH, et al. Tumor diameter and volume assessed by magnetic resonance imaging in the prediction of outcome for invasive cervical cancer. Gynecol Oncol. 2001;82:474–82.PubMedCrossRef

Turan T, Yildirim BA, Tulunay G, Boran N, Kose MF. Prognostic effect of different cut-off values (20 mm, 30 mm, and 40 mm) for clinical tumor size in FIGO stage IB cervical cancer. Surg Oncol. 2010;19:106–13.PubMedCrossRef

Naik R, Jackson KS, Lopes A, Cross P, Henry JA. Laparoscopic assisted radical vaginal hysterectomy versus radical abdominal hysterectomy—a randomized phase II trial: perioperative outcomes and surgicopathological measurements. BJOG. 2010;117:746–51.PubMedCrossRef

Nam JH, Kim JH, Kim DY, Kim MK, Yoo HJ, Kim YM, et al. Comparative study of laparoscopico-vaginal radical hysterectomy and abdominal radical hysterectomy in patients with early cervical cancer. Gynecol Oncol. 2004;92:277–83.PubMedCrossRef

10.

Steed H, Rosen B, Murphy J, Laframboise S, De Petrillo D, Covens A. A comparison of laparoscopic-assisted radical vaginal hysterectomy and radical abdominal hysterectomy in the treatment of cervical cancer. Gynecol Oncol. 2004;93:588–93.PubMedCrossRef

11.

Lee CL, Wu KY, Huang KG, Lee PS, Yen CF. Long-term survival outcomes of laparoscopically assisted radical hysterectomy in treating early-stage cervical cancer. Am J Obstet Gynecol. 2010;203:165.e1–7.

12.

Spirtos NM, Eisenkop SM, Schlaerth JB, Ballon SC. Laparoscopic radical hysterectomy (type III) with aortic and pelvic lymphadenectomy in patients with stage I cervical cancer: surgical morbidity and intermediate follow-up. Am J Obstet Gynecol. 2002;187:340–8.PubMedCrossRef

13.

Mehra G, Weekes A, VanTrappen P, Visvanathan D, Jeyarajah A. Laparoscopic assisted radical vaginal hysterectomy for cervical carcinoma: morbidity and long-term follow-up. Eur J Surg Oncol. 2010;36:304–8.PubMedCrossRef

14.

Querleu D, Morrow CP. Classification of radical hysterectomy. Lancet Oncol. 2008;9:297–303.PubMedCrossRef

15.

Hoh JK, Choi JS, Lee JH, Lee KW, Han JS, Lee EJ. Repeat laparoscopic para-aortic lymphadenectomy for an isolated lymph node recurrence in a patient with stage IB2 cervical cancer. J Minim Invasive Gynecol. 2009;16:781–4.PubMedCrossRef

16.

Sevin BU, Nadji M, Lampe B, Lu Y, Hilsenbeck S, Koechli OR, et al. Prognostic factors of early stage cervical cancer treated by radical hysterectomy. Cancer. 1995;76:1978–86.PubMedCrossRef

17.

Petsuksiri J, Chansilpa Y, Therasakvichya S, Suntornpong N, Thephamongkhol K, Dankulchai P, et al. Treatment options in bulky stage IB cervical carcinoma. Int J Gynecol Cancer. 2008;18:1153–62.PubMedCrossRef

18.

Eifel PJ. Chemoradiation for carcinoma of the cervix: advances and opportunities. Radiat Res. 2000;154:229–36.PubMedCrossRef

19.

Morris M, Eifel PJ, Lu J, Grigsby PW, Levenback C, Stevens RE, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med. 1999;340:1137–43.PubMedCrossRef

20.

Keys HM, Bundy BN, Stehman FB, Muderspach Ll, Chafe WE, Suggs CL 3^rd, et al. Cisplatin, radiation, and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med. 1999;340:1154–61.PubMedCrossRef

21.

Eddy GL, Bundy BN, Creasman WT, Spirtos NM, Mannel RS, Hannigan E, et al. Treatment of (“bulky”) stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: a phase III trial of the gynecologic oncology group. Gynecol Oncol. 2007;106:362–9.PubMedCrossRef

22.

Napolitano U, Imperato F, Mossa B, Framarino ML, Marziani R, Marzetti L. The role of neoadjuvant chemotherapy for squamous cell cervical cancer (Ib-IIIb): a long-term randomized trial. Eur J Gynaecol Oncol. 2003;24:51–9.PubMed

23.

Sardi JE, Giaroli A, Sananes C, Ferreira M, Soderini A, Bermudez A, et al. Long-term follow-up of the first randomized trial using neoadjuvant chemotherapy in stage Ib squamous carcinoma of the cervix: the final results. Gynecol Oncol. 1997;67:61–9.PubMedCrossRef

24.

Cai HB, Chen HZ, Yin HH. Randomized study of preoperative chemotherapy versus primary surgery for stage IB cervical cancer. J Obstet Gynaecol Res. 2006;32:315–23.PubMedCrossRef

25.

Sobiczewski P, Bidzinski M, Derlatka P, Panek G, Danska-Bidzinska A, Gmyrek L, et al. Early cervical cancer managed by laparoscopy and conventional surgery: comparison of treatment results. Int J Gynecol Cancer. 2009;19:1390–5.PubMedCrossRef

26.

Kristensen GB, Abeler VM, Risberg B, Trop C, Bryne M. Tumor size, depth of invasion, and grading of the invasive tumor front are the main prognostic factors in early squamous cell cervical carcinoma. Gynecol Oncol. 1999;74:245–51.PubMedCrossRef

27.

Lee JM, Lee KB, Park CY. Prognostic factors predicting survival in patients with FIGO stage IB cervical cancer treated surgically. Int J Gynaecol Obstet. 2006;94:143–4.PubMedCrossRef

28.

Comerci G, Bolger BS, Flannelly G, Maini M, de Barros Lopes A, Monaghan JM. Prognostic factors in surgically treated stage IB-IIB carcinoma of the cervix with negative lymph nodes. Int J Gynecol Cancer. 1998;8:23–6.PubMedCrossRef

29.

Ryu HS, Kang SB, Kim KT, Chang KH, Kim JW, Kim JH. Efficacy of different types of treatment in FIGO stage IB2 cervical cancer in Korea: results of a multicenter retrospective Korean study (KGOG-1005). Int J Gynecol Cancer. 2007;17:132–6.PubMedCrossRef

Title: Comparison of Survival and Adverse Events between Women with Stage IB1 and Stage IB2 Cervical Cancer Treated by Laparoscopic Radical Vaginal Hysterectomy
Authors: Jin Hwa Hong, MD
Joong Sub Choi, MD
Jung Hun Lee, MD
Chang Eop Son, MD
Seung Wook Jeon, MD
Jong Woon Bae, MD
Jeong Min Eom, MD
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 2/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-011-1904-z

2024 ASCO Annual Meeting

Springer Medicine

Comparison of Survival and Adverse Events between Women with Stage IB1 and Stage IB2 Cervical Cancer Treated by Laparoscopic Radical Vaginal Hysterectomy

Abstract

Purpose

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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