Predictive factors of severe perioperative morbidity of radical hysterectomy with lymphadenectomy in early-stage cervical cancer: A French prospective multicentric cohort of 248 patients.

Details

Serval ID
serval:BIB_058CC7E3DFD4
Type
Article: article from journal or magazin.
Collection
Publications
Title
Predictive factors of severe perioperative morbidity of radical hysterectomy with lymphadenectomy in early-stage cervical cancer: A French prospective multicentric cohort of 248 patients.
Journal
European journal of surgical oncology
Author(s)
Balaya V., Mathevet P., Magaud L., Delomenie M., Bonsang-Kitzis H., Ngô C., Huchon C., Bats A.S., Lecuru F.
ISSN
1532-2157 (Electronic)
ISSN-L
0748-7983
Publication state
Published
Issued date
04/2019
Peer-reviewed
Oui
Volume
45
Number
4
Pages
650-658
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
The purpose of this study was to assess the postoperative morbidity after radical hysterectomy (RH) for early-stage cervical cancer and to determine risk factors of severe perioperative morbidity.
Data of two prospective trials on sentinel node biopsy for cervical cancer (SENTICOL I & II) were analysed. Patients having a radical hysterectomy were included between 2005 and 2012 from 25 French oncologic centers. Postoperative complications were prospectively recorded in a pre-specified analysis.
248 patients met the inclusion criteria. The median age was 44.5 years [25-85]. 88.7% of patients had a stage IB1 disease. There were 71.4% epidermoid carcinomas and 25% adenocarcinomas. 125 patients (50.4%) had a laparoscopic-assisted vaginal RH, 88 patients (35.5%) had a total laparoscopic RH, 26 patients (10.5%) had an open RH and 9 patients (3.6%) had a robotic-assisted RH. Sixteen patients (6.4%) had intraoperative complications. On a multivariate analysis, intraoperative complications were significantly associated with BMI >30 kg/m <sup>2</sup> . The urinary, lymphovascular and neurologic complications rates were respectively 34.3%, 20.6% and 19.8%. 31 patients (12.5%) had severe postoperative complications (Clavien-Dindo ≥ 3 or CTCAE ≥ 3). On multivariate analysis, severe postoperative complications were associated with parametrial involvement, preoperative brachytherapy and inclusion in low surgical skills center.
This study based on prospective data showed that RH has low severe postoperative complications. The main complications were urinary infections and lower limb lymphedema. Patients with early-stage cervical cancer should be referred to expert center to ensure best surgical outcomes.
Keywords
Adenocarcinoma/pathology, Adenocarcinoma/surgery, Adult, Aged, Aged, 80 and over, Body Mass Index, Brachytherapy, Carcinoma, Squamous Cell/pathology, Carcinoma, Squamous Cell/surgery, Disease-Free Survival, Female, France, Humans, Hysterectomy, Vaginal/adverse effects, Intraoperative Complications/etiology, Laparoscopy/adverse effects, Lymph Node Excision/adverse effects, Lymphedema/etiology, Middle Aged, Neoadjuvant Therapy, Neoplasm Recurrence, Local, Neoplasm Staging, Peripheral Nerve Injuries/etiology, Postoperative Complications/etiology, Prospective Studies, Radiotherapy, Adjuvant, Risk Factors, Survival Rate, Urologic Diseases/etiology, Uterine Cervical Neoplasms/pathology, Uterine Cervical Neoplasms/surgery, Cervical cancer, Complications, Morbidity, Radical hysterectomy, Surgery
Pubmed
Web of science
Create date
15/04/2019 8:08
Last modification date
20/08/2019 13:27
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