Oncologic outcome of fertility-sparing radical trachelectomy versus radical hysterectomy for stage IB1 cervical carcinoma Journal Article
| Authors: | Diaz, J. P.; Sonoda, Y.; Leitao, M. M.; Zivanovic, O.; Brown, C. L.; Chi, D. S.; Barakat, R. R.; Abu-Rustum, N. R. |
| Article Title: | Oncologic outcome of fertility-sparing radical trachelectomy versus radical hysterectomy for stage IB1 cervical carcinoma |
| Abstract: | Objective: To compare the oncologic outcomes of women who underwent a fertility-sparing radical trachelectomy (RT) to those who underwent a radical hysterectomy (RH) for stage IB1 cervical carcinoma. Methods: We performed a case-control study of all patients with stage IB1 cervical carcinoma who underwent a vaginal or abdominal RT between 11/01 and 6/07. The control group consisted of patients with stage IB1 disease who underwent an RH between 11/91 and 6/07 and who would be considered candidates for fertility-sparing surgery. Information was extracted from a prospectively acquired database. Recurrence-free and disease-specific survival (RFS and DSS) were estimated using Kaplan-Meier estimates and compared with the log-rank test where indicated. Multivariate analysis was performed using the Cox regression method. Results: Forty stage IB1 patients underwent an RT and 110 patients underwent an RH. There were no statistical differences between the two groups for the following prognostic variables: histology, median number of lymph nodes removed, node positive rate, lymph-vascular space involvement (LVSI), or deep stromal invasion (DSI). The median follow-up for the entire group was 44 months. The 5-year RFS rate was 96% (for the RT group compared to 86% for the RH group (P = NS). On multivariate analysis in this group of stage IB1 lesions, tumor size < 2 cm was not an independent predictor of outcome, but both LVSI and DSI retained independent predictive value (P = 0.033 and 0.005, respectively). Conclusion: For selected patients with stage IB1 cervical cancer, fertility-sparing radical trachelectomy appears to have a similar oncologic outcome to radical hysterectomy. LVSI and DSI appear to be more valuable predictors of outcome than tumor diameter in this subgroup of patients. © 2008 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer survival; controlled study; treatment outcome; middle aged; retrospective studies; young adult; major clinical study; case-control studies; cancer staging; follow up; hysterectomy; lymph node dissection; neoplasm staging; tumor volume; intermethod comparison; gynecologic surgical procedures; pregnancy; radical trachelectomy; fertility; uterine cervical neoplasms; gynecologic surgery; trachelectomy; radical hysterectomy; uterine cervix carcinoma; female fertility; cervical cancer; fertility-sparing |
| Journal Title: | Gynecologic Oncology |
| Volume: | 111 |
| Issue: | 2 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2008-11-01 |
| Start Page: | 255 |
| End Page: | 260 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2008.07.014 |
| PUBMED: | 18755500 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 30" - "Export Date: 17 November 2011" - "CODEN: GYNOA" - "Source: Scopus" |
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