Effect of modified no‐touch laparoscopic radical hysterectomy on outcomes of early stage cervical cancer: A retrospective cohort study

Abstract Objectives We aimed to compare the prognosis of modified no‐touch laparoscopic radical hysterectomy (MLRH) and laparoscopic radical hysterectomy (LRH) on survival in patients with early stage cervical cancer. Materials and Methods The clinicopathological data of patients with stage IB1 and...

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Main Authors: Fangjie He, Songhua Yuan, Xia Chen, Siyou Zhang, Yubin Han, Tiecheng Lin, Bingnan Xu, Shimin Huang, Zhiyin Pan
Format: Article
Language:English
Published: Wiley 2022-06-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.4612
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author Fangjie He
Songhua Yuan
Xia Chen
Siyou Zhang
Yubin Han
Tiecheng Lin
Bingnan Xu
Shimin Huang
Zhiyin Pan
author_facet Fangjie He
Songhua Yuan
Xia Chen
Siyou Zhang
Yubin Han
Tiecheng Lin
Bingnan Xu
Shimin Huang
Zhiyin Pan
author_sort Fangjie He
collection DOAJ
description Abstract Objectives We aimed to compare the prognosis of modified no‐touch laparoscopic radical hysterectomy (MLRH) and laparoscopic radical hysterectomy (LRH) on survival in patients with early stage cervical cancer. Materials and Methods The clinicopathological data of patients with stage IB1 and IIA1 cervical cancer, who underwent radical surgery between 2014 and 2019, were retrospectively reviewed. The 5‐year disease‐free survival (DFS) and overall survival (OS) were compared between the MLRH and LRH groups using the Kaplan–Meier method. Independent prognostic factors for 5‐year DFS and OS were identified using multivariate, forward, stepwise Cox proportional hazards regression models. Results A total of 223 patients with stage IB1 and IIA1 cervical cancer were included. Kaplan–Meier analysis revealed that the 5‐year DFS and OS rates in the MLRH (n = 81) group were significantly higher than those in the LRH group (n = 142) (DFS, 94.5% vs. 78.8%, p = 0.007; OS, 96.7% vs. 87.6%, p = 0.033). No significant differences were identified between the two groups in terms of operative time, blood loss, transfusion requirement, and intraoperative or postoperative complications. MLRH was an independent prognostic factor associated with increased 5‐year DFS (adjusted hazard ratio [HR], 0.202; 95% confidence interval [CI], 0.069–0.594; p = 0.004) and 5‐year OS (adjusted HR, 0.163; 95% CI, 0.035–0.748; p = 0.020). Conclusion The oncologic outcomes were superior with MLRH than with LRH in patients with stage IB1 and IIA1 cervical cancer. Contact of cervical tumor cells with the pelvic cavity likely explains the worse prognosis associated with LRH.
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spelling doaj.art-78e8e5642604484f8a25704618e28b7c2022-12-22T00:28:33ZengWileyCancer Medicine2045-76342022-06-0111112224223210.1002/cam4.4612Effect of modified no‐touch laparoscopic radical hysterectomy on outcomes of early stage cervical cancer: A retrospective cohort studyFangjie He0Songhua Yuan1Xia Chen2Siyou Zhang3Yubin Han4Tiecheng Lin5Bingnan Xu6Shimin Huang7Zhiyin Pan8Department of Obstetrics and Gynecology The First People's Hospital of Foshan Foshan ChinaDepartment of Obstetrics and Gynecology The First People's Hospital of Foshan Foshan ChinaDepartment of Obstetrics and Gynecology The First People's Hospital of Foshan Foshan ChinaDepartment of Obstetrics and Gynecology The First People's Hospital of Foshan Foshan ChinaDepartment of Obstetrics and Gynecology The First People's Hospital of Foshan Foshan ChinaDepartment of Obstetrics and Gynecology The First People's Hospital of Foshan Foshan ChinaDepartment of Obstetrics and Gynecology The First People's Hospital of Foshan Foshan ChinaDepartment of Obstetrics and Gynecology The First People's Hospital of Foshan Foshan ChinaDepartment of Obstetrics and Gynecology The First People's Hospital of Foshan Foshan ChinaAbstract Objectives We aimed to compare the prognosis of modified no‐touch laparoscopic radical hysterectomy (MLRH) and laparoscopic radical hysterectomy (LRH) on survival in patients with early stage cervical cancer. Materials and Methods The clinicopathological data of patients with stage IB1 and IIA1 cervical cancer, who underwent radical surgery between 2014 and 2019, were retrospectively reviewed. The 5‐year disease‐free survival (DFS) and overall survival (OS) were compared between the MLRH and LRH groups using the Kaplan–Meier method. Independent prognostic factors for 5‐year DFS and OS were identified using multivariate, forward, stepwise Cox proportional hazards regression models. Results A total of 223 patients with stage IB1 and IIA1 cervical cancer were included. Kaplan–Meier analysis revealed that the 5‐year DFS and OS rates in the MLRH (n = 81) group were significantly higher than those in the LRH group (n = 142) (DFS, 94.5% vs. 78.8%, p = 0.007; OS, 96.7% vs. 87.6%, p = 0.033). No significant differences were identified between the two groups in terms of operative time, blood loss, transfusion requirement, and intraoperative or postoperative complications. MLRH was an independent prognostic factor associated with increased 5‐year DFS (adjusted hazard ratio [HR], 0.202; 95% confidence interval [CI], 0.069–0.594; p = 0.004) and 5‐year OS (adjusted HR, 0.163; 95% CI, 0.035–0.748; p = 0.020). Conclusion The oncologic outcomes were superior with MLRH than with LRH in patients with stage IB1 and IIA1 cervical cancer. Contact of cervical tumor cells with the pelvic cavity likely explains the worse prognosis associated with LRH.https://doi.org/10.1002/cam4.4612cervical cancerenclosed colpotomylaparoscopic surgeryradical hysterectomyuterine manipulator
spellingShingle Fangjie He
Songhua Yuan
Xia Chen
Siyou Zhang
Yubin Han
Tiecheng Lin
Bingnan Xu
Shimin Huang
Zhiyin Pan
Effect of modified no‐touch laparoscopic radical hysterectomy on outcomes of early stage cervical cancer: A retrospective cohort study
Cancer Medicine
cervical cancer
enclosed colpotomy
laparoscopic surgery
radical hysterectomy
uterine manipulator
title Effect of modified no‐touch laparoscopic radical hysterectomy on outcomes of early stage cervical cancer: A retrospective cohort study
title_full Effect of modified no‐touch laparoscopic radical hysterectomy on outcomes of early stage cervical cancer: A retrospective cohort study
title_fullStr Effect of modified no‐touch laparoscopic radical hysterectomy on outcomes of early stage cervical cancer: A retrospective cohort study
title_full_unstemmed Effect of modified no‐touch laparoscopic radical hysterectomy on outcomes of early stage cervical cancer: A retrospective cohort study
title_short Effect of modified no‐touch laparoscopic radical hysterectomy on outcomes of early stage cervical cancer: A retrospective cohort study
title_sort effect of modified no touch laparoscopic radical hysterectomy on outcomes of early stage cervical cancer a retrospective cohort study
topic cervical cancer
enclosed colpotomy
laparoscopic surgery
radical hysterectomy
uterine manipulator
url https://doi.org/10.1002/cam4.4612
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