Nerve-sparing versus non-nerve-sparing radical hysterectomy: surgical and long-term oncological outcomes
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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
|Antonio Gil-Moreno,||email:||email@example.com, firstname.lastname@example.org|
Keywords: cervical cancer; morbidity; recurrence; surgical treatment; survival
Received: April 16, 2019 Accepted: June 29, 2019 Published: July 16, 2019
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.
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.
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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