Does Vaginal Cuff Creation and Avoidance of a Uterine Manipulator Improve the Prognosis of Total Laparoscopic Radical Hysterectomy for Early Cervical Cancer? A Retrospective Multicenter Study

Does Vaginal Cuff Creation and Avoidance of a Uterine Manipulator Improve the Prognosis of Total Laparoscopic Radical Hysterectomy for Early Cervical Cancer? A Retrospective Multicenter Study

Our goal was to compare the treatment outcomes of open-abdominal radical hysterectomy (O-RH) and total laparoscopic hysterectomy (TLRH) with vaginal cuff creation and without using a uterine manipulator in stage IB1-B2 (tumor size < 4 cm) cervical cancer cases. In this retrospective multicenter a...

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Bibliographic Details
Published in:Cancers Vol. 14; no. 18; p. 4389
Main Authors: Kondo, Eiji, Yoshida, Kenta, Kubo-Kaneda, Michiko, Nii, Masafumi, Okamoto, Kota, Magawa, Shoichi, Nimua, Ryo, Okumura, Asumi, Okugawa, Toshiharu, Yamawaki, Takaharu, Nagao, Kenji, Yoshimura, Kouichi, Watashige, Naoki, Yanoh, Kenji, Ikeda, Tomoaki
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 09-09-2022
MDPI
Subjects:
Abdomen
Cancer therapies
Care and treatment
Cervical cancer
Gynecology
Histology
Hospitals
Hysterectomy
Laparoscopic surgery
Laparoscopy
Laparotomy
Lymph nodes
Lymphatic system
Magnetic resonance imaging
Medical prognosis
Metastases
Metastasis
Methods
Obstetrics
Patients
Prognosis
Surgery
Survival
Tumors
Uterine cancer
Uterus
Vagina
Japan
United States > US
radical hysterectomy
vaginal cuff
cervical cancer
laparoscopic surgery
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Summary:Our goal was to compare the treatment outcomes of open-abdominal radical hysterectomy (O-RH) and total laparoscopic hysterectomy (TLRH) with vaginal cuff creation and without using a uterine manipulator in stage IB1-B2 (tumor size < 4 cm) cervical cancer cases. In this retrospective multicenter analysis, 94 cervical cancer stage IB1-B2 patients who underwent O-RH or TLRH in six hospitals in Japan between September 2016 and July 2020 were included; 36 patients underwent TLRH. Propensity score matching was performed because the tumor diameter was large, and positive cases of lymph node metastases were included in the O-RH group due to selection bias. The primary endpoint was progression-free survival (PFS) and recurrence sites of TLRH and O-RH. PFS and OS (overall survival) were not significant in both the TLRH (n = 27) and O-RH (n = 27) groups; none required conversion to laparotomy. The maximum tumor size was <2 and ≥2 cm in 12 (44.4%) and 15 (55.6%) patients, respectively, in both groups. Reportedly, the TLRH group had lesser bleeding than the O-RH group (p < 0.001). Median follow-up was 33.5 (2−65) and 41.5 (6−75) months in the TLRH and O-RH groups, respectively. PFS and OS were not significantly different between the two groups (TLRH: 92.6%, O-RH: 92.6%; log-rank p = 0.985 and 97.2%, 100%; p = 0.317, respectively). The prognosis of early cervical cancer was not significantly different between TLRH and O-RH. Tumor spillage was prevented by creating a vaginal cuff and avoiding the use of a uterine manipulator. Therefore, TLRH might be considered efficient.
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ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14184389