Objective: Total laparoscopic nerve-sparing radical hysterectomy (TL-NSRH) has been considered a promising approach, however, surgical, clinical, oncological and functional outcomes have not been systematically addressed. We present a large retrospective multi-center experience comparing TL-NSRH vs. open abdominal NSRH (OA-NSRH) for early and locally-advanced cervical cancer, with particular emphasis on post-surgical pelvic function. Methods: All consecutive patients who underwent class C1-NSRH plus bilateral pelvic + para-aortic lymphadenectomy for stage IA2–IIB cervical cancer at 4 Italian gynecologic oncologic centers (Negrar, Varese, Bologna, Avellino) were enrolled. Patients were divided into TL-NSRH and OA-NSRH groups and were investigated with preoperative questionnaires on urinary, rectal and sexual function. Postoperatively, patients filled a questionnaire assessing quality of life, taking into account sexual function and psychological status. Oncological outcomes were analyzed using Kaplan-Meyer method. Results: 301 consecutive patients were included in this study: 170 in the TL-NSRH group and 131 in the OA-NSRH group. Patients in the OA-NSRH group were more likely to experience urinary incontinence and (after 12-months follow-up) urinary retention. No patient in the TL-NSRH group vs. 5 (5.5%) in the OA-NSRH group had complete urinary retention (at the >24-month follow-up [p=0.02]). A total of 20 (11.8%) in the TL-NSRH and 11 (8.4%) patients in the OA-NSRH had recurrence of disease (p=0.44) and 14 (8.2%) and 9 (6.9%) died of disease during follow-up, respectively (p=0.83). Conclusion: Our study shows that TL-NSRH is feasible, safe and effective and conjugates adequate radicality and improvement in post-operative functional outcomes. Oncological outcomes of laparoscopic procedures deserve further investigation.

Ceccaroni M., Roviglione G., Malzoni M., Cosentino F., Spagnolo E., Clarizia R., et al. (2021). Total laparoscopic vs. Conventional open abdominal nerve-sparing radical hysterectomy: Clinical, surgical, oncological and functional outcomes in 301 patients with cervical cancer. JOURNAL OF GYNECOLOGIC ONCOLOGY, 32(1), 1-15 [10.3802/jgo.2021.32.e10].

Total laparoscopic vs. Conventional open abdominal nerve-sparing radical hysterectomy: Clinical, surgical, oncological and functional outcomes in 301 patients with cervical cancer

Spagnolo E.
Membro del Collaboration Group
;
Casadio P.
Membro del Collaboration Group
;
Seracchioli R.
Membro del Collaboration Group
;
2021

Abstract

Objective: Total laparoscopic nerve-sparing radical hysterectomy (TL-NSRH) has been considered a promising approach, however, surgical, clinical, oncological and functional outcomes have not been systematically addressed. We present a large retrospective multi-center experience comparing TL-NSRH vs. open abdominal NSRH (OA-NSRH) for early and locally-advanced cervical cancer, with particular emphasis on post-surgical pelvic function. Methods: All consecutive patients who underwent class C1-NSRH plus bilateral pelvic + para-aortic lymphadenectomy for stage IA2–IIB cervical cancer at 4 Italian gynecologic oncologic centers (Negrar, Varese, Bologna, Avellino) were enrolled. Patients were divided into TL-NSRH and OA-NSRH groups and were investigated with preoperative questionnaires on urinary, rectal and sexual function. Postoperatively, patients filled a questionnaire assessing quality of life, taking into account sexual function and psychological status. Oncological outcomes were analyzed using Kaplan-Meyer method. Results: 301 consecutive patients were included in this study: 170 in the TL-NSRH group and 131 in the OA-NSRH group. Patients in the OA-NSRH group were more likely to experience urinary incontinence and (after 12-months follow-up) urinary retention. No patient in the TL-NSRH group vs. 5 (5.5%) in the OA-NSRH group had complete urinary retention (at the >24-month follow-up [p=0.02]). A total of 20 (11.8%) in the TL-NSRH and 11 (8.4%) patients in the OA-NSRH had recurrence of disease (p=0.44) and 14 (8.2%) and 9 (6.9%) died of disease during follow-up, respectively (p=0.83). Conclusion: Our study shows that TL-NSRH is feasible, safe and effective and conjugates adequate radicality and improvement in post-operative functional outcomes. Oncological outcomes of laparoscopic procedures deserve further investigation.
2021
Ceccaroni M., Roviglione G., Malzoni M., Cosentino F., Spagnolo E., Clarizia R., et al. (2021). Total laparoscopic vs. Conventional open abdominal nerve-sparing radical hysterectomy: Clinical, surgical, oncological and functional outcomes in 301 patients with cervical cancer. JOURNAL OF GYNECOLOGIC ONCOLOGY, 32(1), 1-15 [10.3802/jgo.2021.32.e10].
Ceccaroni M.; Roviglione G.; Malzoni M.; Cosentino F.; Spagnolo E.; Clarizia R.; Casadio P.; Seracchioli R.; Ghezzi F.; Mautone D.; Bruni F.; Uccella ...espandi
File in questo prodotto:
File Dimensione Formato  
JGO 2021.pdf

accesso aperto

Tipo: Versione (PDF) editoriale
Licenza: Licenza per Accesso Aperto. Creative Commons Attribuzione - Non commerciale (CCBYNC)
Dimensione 2.63 MB
Formato Adobe PDF
2.63 MB Adobe PDF Visualizza/Apri
jgo-32-e10-s001.doc

accesso aperto

Tipo: File Supplementare
Licenza: Licenza per Accesso Aperto. Creative Commons Attribuzione - Non commerciale (CCBYNC)
Dimensione 25 kB
Formato Microsoft Word
25 kB Microsoft Word Visualizza/Apri
jgo-32-e10-s002.doc

accesso aperto

Tipo: File Supplementare
Licenza: Licenza per Accesso Aperto. Creative Commons Attribuzione - Non commerciale (CCBYNC)
Dimensione 59 kB
Formato Microsoft Word
59 kB Microsoft Word Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/795876
Citazioni
  • ???jsp.display-item.citation.pmc??? 11
  • Scopus 13
  • ???jsp.display-item.citation.isi??? 13
social impact