Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: A multicenter analysis

Introduction Recent evidence has shown adverse oncological outcomes when minimally invasive surgery is used in early-stage cervical cancer. The objective of this study was to compare disease-free survival in patients that had undergone radical hysterectomy and pelvic lymphadenectomy, either by lapar...

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Autores: Rodriguez, Juliana, Rauh-Hain, Jose Alejandro, Saenz, James, Isla, David Ortiz, Rendon Pereira, Gabriel Jaime
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:Perú
Institución:Instituto Nacional de Enfermedades Neoplásicas
Repositorio:INEN-Institucional
Idioma:inglés
OAI Identifier:oai:repositorio.inen.sld.pe:20.500.14703/445
Acceso en línea:https://doi.org/10.1136/ijgc-2020-002086
https://hdl.handle.net/20.500.14703/445
Access Level:acceso abierto
Palabra clave:uterine cervical neoplasms
hysterectomy
https://purl.org/pe-repo/ocde/ford#3.02.21
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dc.title.none.fl_str_mv Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: A multicenter analysis
title Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: A multicenter analysis
spellingShingle Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: A multicenter analysis
Rodriguez, Juliana
uterine cervical neoplasms
hysterectomy
https://purl.org/pe-repo/ocde/ford#3.02.21
title_short Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: A multicenter analysis
title_full Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: A multicenter analysis
title_fullStr Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: A multicenter analysis
title_full_unstemmed Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: A multicenter analysis
title_sort Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: A multicenter analysis
dc.creator.none.fl_str_mv Rodriguez, Juliana
Rauh-Hain, Jose Alejandro
Saenz, James
Isla, David Ortiz
Rendon Pereira, Gabriel Jaime
author Rodriguez, Juliana
author_facet Rodriguez, Juliana
Rauh-Hain, Jose Alejandro
Saenz, James
Isla, David Ortiz
Rendon Pereira, Gabriel Jaime
author_role author
author2 Rauh-Hain, Jose Alejandro
Saenz, James
Isla, David Ortiz
Rendon Pereira, Gabriel Jaime
author2_role author
author
author
author
dc.subject.none.fl_str_mv uterine cervical neoplasms
hysterectomy
topic uterine cervical neoplasms
hysterectomy
https://purl.org/pe-repo/ocde/ford#3.02.21
dc.subject.ocde.none.fl_str_mv https://purl.org/pe-repo/ocde/ford#3.02.21
description Introduction Recent evidence has shown adverse oncological outcomes when minimally invasive surgery is used in early-stage cervical cancer. The objective of this study was to compare disease-free survival in patients that had undergone radical hysterectomy and pelvic lymphadenectomy, either by laparoscopy or laparotomy. Methods We performed a multicenter, retrospective cohort study of patients with cervical cancer stage IA1 with lymph-vascular invasion, IA2, and IB1 (FIGO 2009 classification), between January 1, 2006 to December 31, 2017, at seven cancer centers from six countries. We included squamous, adenocarcinoma, and adenosquamous histologies. We used an inverse probability of treatment weighting based on propensity score to construct a weighted cohort of women, including predictor variables selected a priori with the possibility of confounding the relationship between the surgical approach and survival. We estimated the HR for all-cause mortality after radical hysterectomy with weighted Cox proportional hazard models. Results A total of 1379 patients were included in the final analysis, with 681 (49.4%) operated by laparoscopy and 698 (50.6%) by laparotomy. There were no differences regarding the surgical approach in the rates of positive vaginal margins, deep stromal invasion, and lymphovascular space invasion. Median follow-up was 52.1 months (range, 0.8-201.2) in the laparoscopic group and 52.6 months (range, 0.4-166.6) in the laparotomy group. Women who underwent laparoscopic radical hysterectomy had a lower rate of disease-free survival compared with the laparotomy group (4-year rate, 88.7% vs 93.0%; HR for recurrence or death from cervical cancer 1.64; 95% CI 1.09-2.46; P=0.02). In sensitivity analyzes, after adjustment for adjuvant treatment, radical hysterectomy by laparoscopy compared with laparotomy was associated with increased hazards of recurrence or death from cervical cancer (HR 1.7; 95% CI 1.13 to 2.57; P=0.01) and death for any cause (HR 2.14; 95% CI 1.05-4.37; P=0.03). Conclusion In this retrospective multicenter study, laparoscopy was associated with worse disease-free survival, compared to laparotomy.
publishDate 2021
dc.date.accessioned.none.fl_str_mv 2025-08-18T02:59:52Z
dc.date.available.none.fl_str_mv 2025-08-18T02:59:52Z
dc.date.issued.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
dc.type.version.none.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.doi.none.fl_str_mv https://doi.org/10.1136/ijgc-2020-002086
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.14703/445
dc.identifier.journal.none.fl_str_mv International Journal of Gynecological Cancer
url https://doi.org/10.1136/ijgc-2020-002086
https://hdl.handle.net/20.500.14703/445
identifier_str_mv International Journal of Gynecological Cancer
dc.language.iso.none.fl_str_mv eng
language eng
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
dc.rights.uri.none.fl_str_mv https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
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dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BMJ Publishing Group
dc.publisher.country.none.fl_str_mv UK
publisher.none.fl_str_mv BMJ Publishing Group
dc.source.none.fl_str_mv reponame:INEN-Institucional
instname:Instituto Nacional de Enfermedades Neoplásicas
instacron:INEN
instname_str Instituto Nacional de Enfermedades Neoplásicas
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spelling Publication2025-08-18T02:59:52Z2025-08-18T02:59:52Z2021https://doi.org/10.1136/ijgc-2020-002086https://hdl.handle.net/20.500.14703/445International Journal of Gynecological CancerIntroduction Recent evidence has shown adverse oncological outcomes when minimally invasive surgery is used in early-stage cervical cancer. The objective of this study was to compare disease-free survival in patients that had undergone radical hysterectomy and pelvic lymphadenectomy, either by laparoscopy or laparotomy. Methods We performed a multicenter, retrospective cohort study of patients with cervical cancer stage IA1 with lymph-vascular invasion, IA2, and IB1 (FIGO 2009 classification), between January 1, 2006 to December 31, 2017, at seven cancer centers from six countries. We included squamous, adenocarcinoma, and adenosquamous histologies. We used an inverse probability of treatment weighting based on propensity score to construct a weighted cohort of women, including predictor variables selected a priori with the possibility of confounding the relationship between the surgical approach and survival. We estimated the HR for all-cause mortality after radical hysterectomy with weighted Cox proportional hazard models. Results A total of 1379 patients were included in the final analysis, with 681 (49.4%) operated by laparoscopy and 698 (50.6%) by laparotomy. There were no differences regarding the surgical approach in the rates of positive vaginal margins, deep stromal invasion, and lymphovascular space invasion. Median follow-up was 52.1 months (range, 0.8-201.2) in the laparoscopic group and 52.6 months (range, 0.4-166.6) in the laparotomy group. Women who underwent laparoscopic radical hysterectomy had a lower rate of disease-free survival compared with the laparotomy group (4-year rate, 88.7% vs 93.0%; HR for recurrence or death from cervical cancer 1.64; 95% CI 1.09-2.46; P=0.02). In sensitivity analyzes, after adjustment for adjuvant treatment, radical hysterectomy by laparoscopy compared with laparotomy was associated with increased hazards of recurrence or death from cervical cancer (HR 1.7; 95% CI 1.13 to 2.57; P=0.01) and death for any cause (HR 2.14; 95% CI 1.05-4.37; P=0.03). Conclusion In this retrospective multicenter study, laparoscopy was associated with worse disease-free survival, compared to laparotomy.application/pdfengBMJ Publishing GroupUKinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/4.0/uterine cervical neoplasmshysterectomyhttps://purl.org/pe-repo/ocde/ford#3.02.21Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: A multicenter analysisinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionreponame:INEN-Institucionalinstname:Instituto Nacional de Enfermedades Neoplásicasinstacron:INENRodriguez, JulianaRauh-Hain, Jose AlejandroSaenz, JamesIsla, David OrtizRendon Pereira, Gabriel JaimeORIGINAL1-s2.0-S1048891X24022989-main.pdf1-s2.0-S1048891X24022989-main.pdfapplication/pdf918149https://repositorio.inen.sld.pe/backend/api/core/bitstreams/85edae9d-a5ca-4f65-9016-d5a359359c3c/contentb112c9dd9febab6063d040c9992a0556MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repositorio.inen.sld.pe/backend/api/core/bitstreams/27ec4f13-a447-4969-aa83-bb1b075aa865/contentbb9bdc0b3349e4284e09149f943790b4MD52TEXT1-s2.0-S1048891X24022989-main.pdf.txt1-s2.0-S1048891X24022989-main.pdf.txtExtracted texttext/plain51638https://repositorio.inen.sld.pe/backend/api/core/bitstreams/ec396441-fde0-4594-82d7-59e3689c6848/content7f54d6c5b9fff36d3eeff268d85c7657MD53THUMBNAIL1-s2.0-S1048891X24022989-main.pdf.jpg1-s2.0-S1048891X24022989-main.pdf.jpgGenerated Thumbnailimage/jpeg52014https://repositorio.inen.sld.pe/backend/api/core/bitstreams/f8064abc-e1b9-439e-bb72-4062eeb7af20/content4b52f5bd84103f21a3180b7d6b713949MD5420.500.14703/445oai:repositorio.inen.sld.pe:20.500.14703/4452026-02-17 09:10:08.822https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessopen.accesshttps://repositorio.inen.sld.peRepositorio Institucional INENrepositorio@inen.sld.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