Perioperative morbidity of radical trachelectomy with lymphadenectomy in early-stage cervical cancer: a French prospective multicentric cohort.

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Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_CF4284D38AB4
Type
Article: article from journal or magazin.
Collection
Publications
Title
Perioperative morbidity of radical trachelectomy with lymphadenectomy in early-stage cervical cancer: a French prospective multicentric cohort.
Journal
Journal of gynecologic oncology
Author(s)
Balaya V., Lécuru F., Magaud L., Ngô C., Huchon C., Bats A.S., Mathevet P.
ISSN
2005-0399 (Electronic)
ISSN-L
2005-0380
Publication state
Published
Issued date
05/2019
Peer-reviewed
Oui
Volume
30
Number
3
Pages
e34
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
The aim of this study was to determine the predictive factors of postoperative morbidity of patients who have undergone a radical trachelectomy (RT) for early-stage cervical cancer and to assess the oncologic outcomes.
We retrospectively analysed the data of 2 prospective trials on sentinel node biopsy for cervical cancer (SENTICOL I and II). Patients having a RT for early-stage cervical cancer with negative sentinel lymph node and safe margins, were included.
Forty-nine patients met the inclusion criteria. Forty-five patients had a laparoscopic-assisted vaginal technique and 4 patients a total laparoscopic technique. The median age was 32 years (range, 22-46 years). 83.7% of patients had a stage IB1 disease. There were 63.3% squamous cell carcinomas and 34.7% adenocarcinomas. The median follow-up was 46 months (range, 1-85 months). Two patients (3.3%) had a severe postoperative complication (Clavien-Dindo ≥III and/or CTCAE ≥3). The main postoperative complications were urinary (28.6%), lymphovascular (26.5%) and neurologic (14.3%). On a multivariate analysis, postoperative complications were significantly associated with history of pelvic surgery and IB1 International Federation of Gynecology and Obstetrics stage. Inclusion in high surgical skills centers decrease the risk of postoperative complications. During the follow-up, 3 patients (6.1%) had a local recurrence and one patient died from a breast cancer. Between group with complications and group without any complications, overall survival and recurrence-free survival did not significantly differ at 5-year of follow-up.
RT has few severe postoperative complications and appears as a safe alternative to spare fertility of young patients. To guarantee best surgical outcomes, patients should be referred to expert center.
Keywords
Adenocarcinoma/epidemiology, Adenocarcinoma/pathology, Adenocarcinoma/surgery, Adult, Carcinoma, Squamous Cell/epidemiology, Carcinoma, Squamous Cell/pathology, Carcinoma, Squamous Cell/surgery, Databases as Topic, Female, France/epidemiology, Humans, Lymph Node Excision/adverse effects, Lymph Node Excision/statistics & numerical data, Middle Aged, Morbidity, Neoplasm Staging, Pelvis/surgery, Perioperative Period/statistics & numerical data, Postoperative Complications/epidemiology, Randomized Controlled Trials as Topic/statistics & numerical data, Retrospective Studies, Sentinel Lymph Node Biopsy/adverse effects, Sentinel Lymph Node Biopsy/methods, Sentinel Lymph Node Biopsy/statistics & numerical data, Trachelectomy/adverse effects, Trachelectomy/statistics & numerical data, Uterine Cervical Neoplasms/epidemiology, Uterine Cervical Neoplasms/pathology, Uterine Cervical Neoplasms/surgery, Young Adult, Cervical Cancer, Trachelectomy
Pubmed
Web of science
Open Access
Yes
Create date
07/04/2019 15:52
Last modification date
04/01/2020 7:17
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