Research Papers:

Urodynamic outcomes after pelvic nerve-sparing radical hysterectomy with or without neoadjuvant chemotherapy

Satoshi Tsunetoh _, Yoshito Terai, Masaaki Takai, Satoe Fujiwara, Yoshimichi Tanaka, Tomohito Tanaka, Hiroshi Sasaki, Naokazu Ibuki, Takanobu Ubai, Kazuhiro Yamamoto, Haruhito Azuma and Masahide Ohmichi

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Oncotarget. 2019; 10:5207-5216. https://doi.org/10.18632/oncotarget.27147

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Satoshi Tsunetoh1, Yoshito Terai4, Masaaki Takai1, Satoe Fujiwara1, Yoshimichi Tanaka1, Tomohito Tanaka1, Hiroshi Sasaki1, Naokazu Ibuki2, Takanobu Ubai5, Kazuhiro Yamamoto3, Haruhito Azuma2 and Masahide Ohmichi1

1 Department of Obstetrics and Gynecology, Osaka Medical College, Takatsuki, Japan

2 Department of Urology, Osaka Medical College, Takatsuki, Japan

3 Department of Radiology, Osaka Medical College, Takatsuki, Japan

4 Department of Obstetrics and Gynecology, Kobe University, Kobe, Japan

5 Department of Urology, Takatsuki General Hospital, Takatsuki, Japan

Correspondence to:

Satoshi Tsunetoh,email: [email protected]

Keywords: uterine cervical cancer; nerve-sparing radical hysterectomy (NSRH); urodynamic study; neoadjuvant chemotherapy; balloon-occluded arterial infusion (BOAI)

Received: February 15, 2019     Accepted: July 29, 2019     Published: August 27, 2019


OBJECTIVE: Our purposes of this study were to characterize a group of bulky cervical cancer patients who underwent a nerve sparing radical hysterectomy (NSRH) with or without neoadjuvant chemotherapy (NAC), to compare surgical outcomes and the preservation of bladder function, and to compare prognoses.

RESULTS: Fifty-three patients had NSRH without NAC (Group A), and 33 patients had NSRH after NAC (Group B). With regard to prognostic factors, there was only a significant difference between both groups with regard to lymph node metastasis (15% vs 42%, P = 0.01). Moreover, bladder function in Group B patients improved to the same extent as the preoperative rate three months postoperatively. These data were similar to the results in Group A. With regard to overall survival, the 5-year survival rate was 98.1% (95% confidence interval (CI) 87.8–99.7) in Group A and 86.7% (95% CI 71.7–96.7) in Group B (P > 0.1).

METHODS: We retrospectively identified 86 patients with cervical cancer who underwent NSRH at Osaka Medical College from May 2009 to November 2016. NAC was performed via balloon occluded arterial infusion. We extracted data on the patient's stage of progress, tumor volume, histological subtype, bleeding volume, urodynamic study results, and postoperative complications. The data were divided into two groups - those patients who received NAC and those who did not - and then compared.

CONCLUSIONS: According to our analysis, NSRH surgery after NAC via balloon occluded arterial infusion brings beneficial results to patients with bulky IB2 to IIB cervical cancers.

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