Surveillance of radical hysterectomy for early-stage cervical cancer in the early experienced period of minimally invasive surgery in Japan,International Journal of Clinical Oncology

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Surveillance of radical hysterectomy for early-stage cervical cancer in the early experienced period of minimally invasive surgery in Japan
International Journal of Clinical Oncology ( IF 2.4 ) Pub Date : 2021-08-25 , DOI: 10.1007/s10147-021-02017-4
Tsuyoshi Ohta ₁ , Satoru Nagase ₁ , Yosuke Okui ₁ , Takayuki Enomoto ₂ , Wataru Yamagami ₃ , Mikio Mikami ₄ , Hideki Tokunaga ₅ , Kazuhiko Ino ₆ , Kimio Ushijima ₇ , Makio Shozu ₈ , Hironori Tashiro ₉ , Masaki Mandai ₁₀ , Shingo Miyamoto ₁₁ , Ken-Ichirou Morishige ₁₂ , Yoshio Yoshida ₁₃ , Kiyoshi Yoshino ₁₄ , Toshiaki Saito ₁₅ , Eiji Kobayashi ₁₆ , Hiroaki Kobayashi ₁₇ , Munetaka Takekuma ₁₈ , Yoshito Terai ₁₉ , Takuma Fujii ₂₀ , Hiroyuki Kanao ₂₁ , Daisuke Aoki ₃ , Hidetaka Katabuchi ₉ , Nobuo Yaegashi ₅

Affiliation

Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan.
Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan.
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Japan.
Department of Gynecology and Obstetrics, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama, Japan.
Department of Obstetrics and Gynecology,, Kurume University School of Medicine, Kurume, Japan.
Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Obstetrics and Gynecology, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
Department of Obstetrics and Gynecology, Gifu University Graduate School of Medicine, Gifu, Japan.
Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Fukui, Yoshida, Japan.
Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Gynecology Service, National Kyushu Cancer Center, Fukuoka, Japan.
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
Department of Gynecologic Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Aichi, Japan.
Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan.

Objective

The purpose of our study was to conduct a detailed survey of radical hysterectomy in Japanese patients with early-stage cervical cancer, and to compare oncologic outcomes between open and minimally invasive radical hysterectomy.

Methods

In Japan during 2015, the medical records of 929 patients with FIGO stage IB1 and IIA disease treated with radical hysterectomy were retrospectively reviewed. We assessed patients’ characteristics, disease-free survival (DFS), overall survival (OS) and prognostic factors for survival.

Results

The median patient age was 44 (20–80) years. Most patients (94.4%) had stage IB1 disease. Of the patients who underwent radical hysterectomy, 91.2% underwent open surgery and 8.8% underwent minimally invasive surgery (MIS). The median follow-up period was 40.8 months (range, 0.49–51.1 months). The rate of DFS and OS at 4 years in all patients was 88.3% and 96.4%, respectively. Multivariate analysis identified age (≥ 47), adenocarcinoma histology, tumor size (≥ 2 cm), parametrial invasion, positive lymph node metastasis and institutional accreditation as independent predictors of recurrence, and adenocarcinoma, other cell types, and positive lymph node metastasis as independent predictors of death. Oncologic outcomes in all patients were similar between open and MIS, including DFS and OS.

Conclusion

The survival rate of the Japanese patients underwent radical hysterectomy for early-stage cervical cancer was favorable. No significant differences were observed for DFS and OS between open and MIS performed by a limited number of surgeons at a limited number of facilities in Japan. Further investigations are required to identify the appropriate patients might benefit from MIS.

中文翻译：

日本微创手术早期体验期早期宫颈癌根治性子宫切除术的监测

客观的

我们研究的目的是对日本早期宫颈癌患者的根治性子宫切除术进行详细调查，并比较开放性和微创根治性子宫切除术之间的肿瘤学结果。

方法

回顾性分析了 2015 年日本 929 例采用根治性子宫切除术治疗的 FIGO IB1 和 IIA 期患者的病历。我们评估了患者的特征、无病生存期 (DFS)、总生存期 (OS) 和生存的预后因素。

结果

患者的中位年龄为 44 (20-80) 岁。大多数患者 (94.4%) 患有 IB1 期疾病。在接受根治性子宫切除术的患者中，91.2% 接受了开放手术，8.8% 接受了微创手术 (MIS)。中位随访期为 40.8 个月（范围为 0.49-51.1 个月）。所有患者 4 年的 DFS 和 OS 率分别为 88.3% 和 96.4%。多变量分析将年龄（≥ 47 岁）、腺癌组织学、肿瘤大小（≥ 2 cm）、宫旁浸润、阳性淋巴结转移和机构认证确定为复发的独立预测因素，而腺癌、其他细胞类型和阳性淋巴结转移为独立预测因素死亡的预兆。所有患者的肿瘤学结果在开放性和 MIS 之间相似，包括 DFS 和 OS。