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Total Laparoscopic Versus Laparotomic Radical Hysterectomy and Lymphadenectomy in Cervical Cancer: An Observational Study of 13-Year Experience.

Xiao M, Zhang Z - Medicine (Baltimore) (2015)

Bottom Line: In the present study, patients in total laparoscopy group were associated with superior surgical outcomes, such as significantly lower blood transfusion compared to those in laparotomy group.Furthermore, patients had significantly lower postoperative complication rate in total laparoscopy group compared with that in laparotomy group (24.5% vs 52.1%) (P = 0.001).Three patients (2.8%) in total laparoscopy group had unplanned conversion to laparotomy.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Affiliated to Capital Medical University, Beijing, China.

ABSTRACT
This article aims to review our 13-year experience in the treatment of patients with cervical cancer by comparing total laparoscopic radical hysterectomy and lymphadenectomy with laparotomy.We reviewed all patients undergoing total laparoscopic or laparotomic radical hysterectomy and lymphadenectomy because of cervical cancer between 2001 and 2014 in our hospital.In total, 154 eligible patients with International Federation of Gynecology and Obstetrics Ia-IIb were enrolled, including 106 patients undergoing total laparoscopic procedure and 48 patients undergoing laparotomic procedure. In the present study, patients in total laparoscopy group were associated with superior surgical outcomes, such as significantly lower blood transfusion compared to those in laparotomy group. Furthermore, patients had significantly lower postoperative complication rate in total laparoscopy group compared with that in laparotomy group (24.5% vs 52.1%) (P = 0.001). Three patients (2.8%) in total laparoscopy group had unplanned conversion to laparotomy. Disease-free survival rates were 89.7% and 88.9% in total laparoscopy and laparotomy groups (P = 0.39), respectively, and overall survival rates were 90.2% in total laparoscopy group and 91.3% in laparotomy group (P = 0.40).Total laparoscopic procedure is a surgically and oncologically safe and reliable alternative to laparotomic procedure in the treatment for cervical cancer.

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Related in: MedlinePlus

(A) Disease-free survival and overall survival for patients undergoing total laparoscopic radical hysterectomy (TLRH) or abdominal radical hysterectomy (ARH); (B) Disease-free survival and overall survival for patients with early-stage cervical cancer undergoing TLRH or ARH, and with locally advanced disease receiving neoadjuvant chemotherapy (NACT) along with TLRH or NACT along with ARH.
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Figure 2: (A) Disease-free survival and overall survival for patients undergoing total laparoscopic radical hysterectomy (TLRH) or abdominal radical hysterectomy (ARH); (B) Disease-free survival and overall survival for patients with early-stage cervical cancer undergoing TLRH or ARH, and with locally advanced disease receiving neoadjuvant chemotherapy (NACT) along with TLRH or NACT along with ARH.

Mentions: By December 31, 2014, the final follow-up day, we have successfully followed up all patients in outpatient clinic or by telephone; 6 patients (5.7%) in total laparoscopy group and 5 patients (10.4%) in laparotomy group had documented histopathologically confirmed recurrence, and 10 patients have died, with 4 patients assigned to total laparoscopy group and 6 to laparotomy group. One patient died from intercurrent disease and 1 from fatal cerebral hemorrhage in laparotomy group and others from cervical cancer. Although the follow-up time was a little longer in laparotomy group than that in the total laparoscopy group (mean, 64.6 vs 48.2 months, Pā€Š=ā€Š0.02), no between-group differences were observed in the survival outcomes (Table 3); the DFS and OS for cervical cancer patients undergoing total laparoscopic or laparotomic procedure were separately shown in Figure 2.


Total Laparoscopic Versus Laparotomic Radical Hysterectomy and Lymphadenectomy in Cervical Cancer: An Observational Study of 13-Year Experience.

Xiao M, Zhang Z - Medicine (Baltimore) (2015)

(A) Disease-free survival and overall survival for patients undergoing total laparoscopic radical hysterectomy (TLRH) or abdominal radical hysterectomy (ARH); (B) Disease-free survival and overall survival for patients with early-stage cervical cancer undergoing TLRH or ARH, and with locally advanced disease receiving neoadjuvant chemotherapy (NACT) along with TLRH or NACT along with ARH.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554128&req=5

Figure 2: (A) Disease-free survival and overall survival for patients undergoing total laparoscopic radical hysterectomy (TLRH) or abdominal radical hysterectomy (ARH); (B) Disease-free survival and overall survival for patients with early-stage cervical cancer undergoing TLRH or ARH, and with locally advanced disease receiving neoadjuvant chemotherapy (NACT) along with TLRH or NACT along with ARH.
Mentions: By December 31, 2014, the final follow-up day, we have successfully followed up all patients in outpatient clinic or by telephone; 6 patients (5.7%) in total laparoscopy group and 5 patients (10.4%) in laparotomy group had documented histopathologically confirmed recurrence, and 10 patients have died, with 4 patients assigned to total laparoscopy group and 6 to laparotomy group. One patient died from intercurrent disease and 1 from fatal cerebral hemorrhage in laparotomy group and others from cervical cancer. Although the follow-up time was a little longer in laparotomy group than that in the total laparoscopy group (mean, 64.6 vs 48.2 months, Pā€Š=ā€Š0.02), no between-group differences were observed in the survival outcomes (Table 3); the DFS and OS for cervical cancer patients undergoing total laparoscopic or laparotomic procedure were separately shown in Figure 2.

Bottom Line: In the present study, patients in total laparoscopy group were associated with superior surgical outcomes, such as significantly lower blood transfusion compared to those in laparotomy group.Furthermore, patients had significantly lower postoperative complication rate in total laparoscopy group compared with that in laparotomy group (24.5% vs 52.1%) (P = 0.001).Three patients (2.8%) in total laparoscopy group had unplanned conversion to laparotomy.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Affiliated to Capital Medical University, Beijing, China.

ABSTRACT
This article aims to review our 13-year experience in the treatment of patients with cervical cancer by comparing total laparoscopic radical hysterectomy and lymphadenectomy with laparotomy.We reviewed all patients undergoing total laparoscopic or laparotomic radical hysterectomy and lymphadenectomy because of cervical cancer between 2001 and 2014 in our hospital.In total, 154 eligible patients with International Federation of Gynecology and Obstetrics Ia-IIb were enrolled, including 106 patients undergoing total laparoscopic procedure and 48 patients undergoing laparotomic procedure. In the present study, patients in total laparoscopy group were associated with superior surgical outcomes, such as significantly lower blood transfusion compared to those in laparotomy group. Furthermore, patients had significantly lower postoperative complication rate in total laparoscopy group compared with that in laparotomy group (24.5% vs 52.1%) (P = 0.001). Three patients (2.8%) in total laparoscopy group had unplanned conversion to laparotomy. Disease-free survival rates were 89.7% and 88.9% in total laparoscopy and laparotomy groups (P = 0.39), respectively, and overall survival rates were 90.2% in total laparoscopy group and 91.3% in laparotomy group (P = 0.40).Total laparoscopic procedure is a surgically and oncologically safe and reliable alternative to laparotomic procedure in the treatment for cervical cancer.

Show MeSH
Related in: MedlinePlus