Open AccessSurgical route and pathological risk factors in early cervical cancer - Node Zero (SURPEC-N0)
Author(s) -
T S Shylasree,
Stuti Gupta,
Akshay Patil,
Abhishek Singh,
Amita Maheshwari,
Santosh Me,
Supriya Chopra,
Lavanya Gurram,
Palak Popat,
Umesh Mahantshetty,
Rajendra Kerkar
Publication year - 2022
Publication title -
journal of cancer metastasis and treatment
Language(s) - English
Resource type - Journals
eISSN - 2454-2857
pISSN - 2394-4722
DOI - 10.20517/2394-4722.2022.10
Subject(s) - medicine , cervical cancer , radical hysterectomy , lymph node , retrospective cohort study , propensity score matching , surgery , cohort , stage (stratigraphy) , hysterectomy , tertiary referral hospital , cancer , paleontology , biology
Aim: The aim of this study is to compare disease-free survival (DFS) and overall survival (OS) in patients with stage I cervical cancer (≤ 4cms, lymph node-negative) undergoing open radical hysterectomy (ORH) vs. minimally invasive radical hysterectomy (MIRH). Methods: All patients undergoing radical hysterectomy between January 2012-December 2018 from the largest tertiary referral cancer centre were included. A 1:1 propensity matching was done based on four independent prognostic factors to compare DFS and OS with the route of surgery. Results: One hundred and ninety-nine patients were included during the study period. The median age of the cohort was 50 years. The median follow-up of patients was 47 months. Following 1:1 propensity matching, a total of 174 patients were analysed for DFS and OS in ORH (n = 87) and MIRH (n = 87) groups. Protective measure was used in two-thirds of the patients during MIRH. Twenty-nine patients (16.7%) had recurrences. For the matched cohort (n = 174), the DFS at 36 and 60 months was 84.8% (78.1%-89.6%) and 81% (73.4%-86.6%) respectively and the OS was 96.5% (91.7%-98.5%) and 95.6% (90.3%-98%) respectively. There was no statistically significant difference in DFS or OS between ORH and MIRH. Conclusion: The present study showed no difference in oncological outcomes in MIRH compared to ORH. Retrospective audits on patient characteristics such as screening/vaccination history along with surgical technique/load and matching for crucial risk factors should be factored in future studies to eliminate the possible methodological errors.