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The Role of Laparoscopic Radical Hysterectomy in Early-Stage Adenocarcinoma of the Uterine Cervix

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

To compare long-term survival outcomes and patterns of recurrence of laparoscopic radical hysterectomy (LRH) and open radical hysterectomy (ORH) in early-stage cervical adenocarcinoma.

Methods

The medical records of 293 patients with stage IA2-IIA cervical adenocarcinomas who underwent radical hysterectomy were retrospectively reviewed.

Results

In total, 186 patients underwent LRH and 107 underwent ORH. There was no difference between the two surgery groups in clinicopathologic characteristics. There were no differences in disease-free survival (DFS) and overall survival (OS) between the LRH and ORH groups (88.7 vs. 84.1 %, P = 0.725; and 93.0 vs. 86.9 %, P = 0.735) for univariate analysis and multivariate analysis after adjusting for other significant prognostic factors. There was no difference in the patterns of recurrence between the two surgery groups (P = 0.220). The median time interval between surgery and the first recurrence were 25 months (range, 3–100 months) for LRH group and 14 months (range, 3–128 months) for ORH group (P = 0.230). The LRH group showed significantly fewer postoperative complications (P < 0.001), less estimated blood loss (P < 0.001), faster bowel movement recovery (P < 0.001), shorter postoperative hospital stay (P < 0.001), and a lower rate of wound dehiscence, ileus, lymphedema, infected lymphocele, and pelvic abscess (P = 0.004, 0.011, 0.017, and 0.040, respectively).

Conclusions

LRH has comparable survival outcomes with ORH and did not affect the pattern of recurrence in early-stage adenocarcinoma of the uterine cervix. The surgical outcomes were more favorable than ORH.

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References

  1. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.

    Article  PubMed  Google Scholar 

  2. Jung KW, Won YJ, Oh CM, et al. Prediction of cancer incidence and mortality in Korea, 2015. Cancer Res Treat. 2015;47:142–8.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Jung KW, Won YJ, Kong HJ, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat. 2015;47:127–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Kosary CL. FIGO stage, histology, histologic grade, age and race as prognostic factors in determining survival for cancers of the female gynecological system: an analysis of 1973-87 SEER cases of cancers of the endometrium, cervix, ovary, vulva, and vagina. Semin Surg Oncol. 1994;10:31–46.

    Article  CAS  PubMed  Google Scholar 

  5. Vinh-Hung V, Bourgain C, Vlastos G, et al. Prognostic value of histopathology and trends in cervical cancer: a SEER population study. BMC Cancer. 2007;7:164.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Attanoos R, Nahar K, Bigrigg A, et al. Primary adenocarcinoma of the cervix: a clinicopathologic study of prognostic variables in 55 cases. Int J Gynecol Cancer. 1995;5:179–86.

    Article  PubMed  Google Scholar 

  7. Quinn MA. Adenocarcinoma of the cervix: are there arguments for a different treatment policy? Curr Opin Obstet Gynecol. 1997;9:21–4.

    Article  CAS  PubMed  Google Scholar 

  8. Berek JS, Hacker NF, Fu YS, et al. Adenocarcinoma of the uterine cervix: histologic variables associated with lymph node metastasis and survival. Obstet Gynecol. 1985;65:46–52.

    CAS  PubMed  Google Scholar 

  9. Hopkins MP, Morley GW. A comparison of adenocarcinoma and squamous cell carcinoma of the cervix. Obstet Gynecol. 1991;77:912–7.

    CAS  PubMed  Google Scholar 

  10. Kjorstad KE. Adenocarcinoma of the uterine cervix. Gynecol Oncol. 1977;5:219–23.

    Article  CAS  PubMed  Google Scholar 

  11. Gien LT, Beauchemin MC, Thomas G. Adenocarcinoma: a unique cervical cancer. Gynecol Oncol. 2010;116:140–6.

    Article  CAS  PubMed  Google Scholar 

  12. Zheng T, Holford TR, Ma Z, et al. The continuing increase in adenocarcinoma of the uterine cervix: a birth cohort phenomenon. Int J Epidemiol. 1996;25:252–8.

    Article  CAS  PubMed  Google Scholar 

  13. Vizcaino AP, Moreno V, Bosch FX, et al. International trends in the incidence of cervical cancer: I. Adenocarcinoma and adenosquamous cell carcinomas. Int J Cancer. 1998;75:536–45.

    Article  CAS  PubMed  Google Scholar 

  14. Shimada M, Kigawa J, Nishimura R, et al. Ovarian metastasis in carcinoma of the uterine cervix. Gynecol Oncol. 2006;101:234–7.

    Article  PubMed  Google Scholar 

  15. Kuji S, Hirashima Y, Komeda S, et al. The relationship between positive peritoneal cytology and the prognosis of patients with FIGO stage I/II uterine cervical cancer. J Gynecol Oncol. 2014;25:90–6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Fujiwara K, Monk B, Devouassoux-Shisheboran M. Adenocarcinoma of the uterine cervix: why is it different? Curr Oncol Rep. 2014;16:416.

    Article  PubMed  Google Scholar 

  17. Adegoke O, Kulasingam S, Virnig B. Cervical cancer trends in the United States: a 35-year population-based analysis. J Womens Health (Larchmt). 2012;21:1031–7.

    Article  PubMed Central  Google Scholar 

  18. Baalbergen A, Veenstra Y, Stalpers L. Primary surgery versus primary radiotherapy with or without chemotherapy for early adenocarcinoma of the uterine cervix. Cochrane Database Syst Rev. 2013:CD006248.

  19. Pellegrino A, Vizza E, Fruscio R, et al. Total laparoscopic radical hysterectomy and pelvic lymphadenectomy in patients with Ib1 stage cervical cancer: analysis of surgical and oncological outcome. Eur J Surg Oncol. 2009;35:98–103.

    Article  CAS  PubMed  Google Scholar 

  20. Chen Y, Xu H, Li Y, et al. The outcome of laparoscopic radical hysterectomy and lymphadenectomy for cervical cancer: a prospective analysis of 295 patients. Ann Surg Oncol. 2008;15:2847–55.

    Article  PubMed  Google Scholar 

  21. Abu-Rustum NR, Gemignani ML, Moore K, et al. Total laparoscopic radical hysterectomy with pelvic lymphadenectomy using the argon-beam coagulator: pilot data and comparison to laparotomy. Gynecol Oncol. 2003;91:402–9.

    Article  PubMed  Google Scholar 

  22. Piver MS, Chung WS. Prognostic significance of cervical lesion size and pelvic node metastases in cervical carcinoma. Obstet Gynecol. 1975;46:507–10.

    CAS  PubMed  Google Scholar 

  23. Nam JH, Park JY, Kim DY, et al. Laparoscopic versus open radical hysterectomy in early-stage cervical cancer: long-term survival outcomes in a matched cohort study. Ann Oncol. 2012;23:903–11.

    Article  PubMed  Google Scholar 

  24. Sedlis A, Bundy BN, Rotman MZ, et al. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: a gynecologic oncology group study. Gynecol Oncol. 1999;73:177–83.

    Article  CAS  PubMed  Google Scholar 

  25. Chargui R, Damak T, Khomsi F, et al. Prognostic factors and clinicopathologic characteristics of invasive adenocarcinoma of the uterine cervix. Am J Obstet Gynecol. 2006;194:43–8.

    Article  PubMed  Google Scholar 

  26. Landoni F, Maneo A, Colombo A, et al. Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet. 1997;350:535–40.

    Article  CAS  PubMed  Google Scholar 

  27. Trimble EL, Harlan LC, Gius D, et al. Patterns of care for women with cervical cancer in the United States. Cancer. 2008;113:743–9.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kato T, Watari H, Takeda M, et al. Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy. J Gynecol Oncol. 2013;24:222–8.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Park JY, Kim DY, Kim JH, et al. Outcomes after radical hysterectomy in patients with early-stage adenocarcinoma of uterine cervix. Br J Cancer. 2010;102:1692–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Fujiwara H, Yokota H, Monk B, et al. Gynecologic Cancer InterGroup (GCIG) consensus review for cervical adenocarcinoma. Int J Gynecol Cancer. 2014;24:S96–101.

    Article  PubMed  Google Scholar 

  31. Kucukmetin A, Biliatis I, Naik R, et al. Laparoscopically assisted radical vaginal hysterectomy versus radical abdominal hysterectomy for the treatment of early cervical cancer. Cochrane Database Syst Rev. 2013;10:CD006651.

  32. Park JY, Kim DY, Kim JH, et al. Laparoscopic versus open radical hysterectomy in patients with stage IB2 and IIA2 cervical cancer. J Surg Oncol. 2013;108:63–9.

    Article  PubMed  Google Scholar 

  33. Park JY, Kim DY, Kim JH, et al. Laparoscopic compared with open radical hysterectomy in obese women with early-stage cervical cancer. Obstet Gynecol. 2012;119:1201–9.

    Article  PubMed  Google Scholar 

  34. Park JY, Kim DY, Kim JH, et al. Laparoscopic versus open radical hysterectomy for elderly patients with early-stage cervical cancer. Am J Obstet Gynecol. 2012;207:195 e1–8.

    Google Scholar 

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Disclosure

The authors declare that there are no conflict of interest.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jeong-Yeol Park MD, Daeyeon Kim MD, PhD, Dae-Shik Suh MD, PhD, Jong-Hyeok Kim MD, PhD, Yong-Man Kim MD, PhD, Young-Tak Kim MD, PhD & Joo-Hyun Nam MD, PhD

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  1. Jeong-Yeol Park MD
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  2. Daeyeon Kim MD, PhD
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  3. Dae-Shik Suh MD, PhD
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  4. Jong-Hyeok Kim MD, PhD
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  6. Young-Tak Kim MD, PhD
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  7. Joo-Hyun Nam MD, PhD
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Correspondence to Joo-Hyun Nam MD, PhD.

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Park, JY., Kim, D., Suh, DS. et al. The Role of Laparoscopic Radical Hysterectomy in Early-Stage Adenocarcinoma of the Uterine Cervix. Ann Surg Oncol 23 (Suppl 5), 825–833 (2016). https://doi.org/10.1245/s10434-016-5489-4

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  • DOI: https://doi.org/10.1245/s10434-016-5489-4

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