Oncotarget

Research Papers:

Nerve-sparing versus non-nerve-sparing radical hysterectomy: surgical and long-term oncological outcomes

Antonio Gil-Moreno _, Melchor Carbonell-Socias, Sabina Salicrú _, Melissa Bradbury, Ángel García, Ramona Vergés, Oriol Puig Puig, José Luís Sánchez-Iglesias, Silvia Cabrera-Díaz, Javier de la Torre, Natalia R. Gómez-Hidalgo, Assumpció Pérez-Benavente and Berta Díaz-Feijoo

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Oncotarget. 2019; 10:4598-4608. https://doi.org/10.18632/oncotarget.27078

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Abstract

Antonio Gil-Moreno1, Melchor Carbonell-Socias1, Sabina Salicrú1, Melissa Bradbury1, Ángel García2, Ramona Vergés3, Oriol Puig Puig1, José Luís Sánchez-Iglesias1, Silvia Cabrera-Díaz1, Javier de la Torre1, Natalia R. Gómez-Hidalgo1, Assumpció Pérez-Benavente1 and Berta Díaz-Feijoo1

1 Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain

2 Department of Pathology, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain

3 Radiotherapy Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain

Correspondence to:

Antonio Gil-Moreno,email: agil@vhebron.net, antonioimma@yahoo.es
Sabina Salicrú,email: ssalicru@vhebron.net

Keywords: cervical cancer; morbidity; recurrence; surgical treatment; survival

Received: April 16, 2019     Accepted: June 29, 2019     Published: July 16, 2019

ABSTRACT

Objectives

There are controversies regarding the long-term oncological safety of preservation of pelvic innervation during radical hysterectomy (RH). This study aimed to analyze the feasibility and safety of nerve-sparing radical hysterectomy (NSRH) for cervical cancer compared with non-NSRH following 17 years of experience in a tertiary cancer referral center.

Materials and Methods

Between May 1999 and June 2016, all patients who underwent RH for cervical cancer were followed-up prospectively. Comparison analyses regarding surgical outcomes, complications, overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) were performed between patients treated with NSRH and non-NSRH.

Results

A total of 188 patients were included (113 non-NSRH and 75 NSRH). The median follow-up was 112 months. Estimated blood loss and hospital stay were all significantly lower in the NSRH group. Overall intraoperative complication rate (p = 0.02) and need for transfusion (p = 0.016) were lower in the NSRH group. There were no differences in the median operation time, OS, DFS, CSS, or recurrence rates between the NSRH and non-NSRH group.

Conclusions

Our study provides a wide perspective on the developments of nerve-sparing procedures for the management of women with early-stage cervical cancer. Our results suggest that NSRH is a feasible and safe procedure, with reduced morbidity outcomes.


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