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Article

Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery?

1
Gynecologic Oncology Unit, Clínic Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic Barcelona, 08036 Barcelona, Spain
2
Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
3
Surgery and Medical-Surgical Specialties Department, Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain
4
Department of Pathology, Hospital Clínic Barcelona, 08036 Barcelona, Spain
5
Institut de Salut Global de Barcelona (ISGlobal), Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain
6
Department of Nuclear Medicine, Hospital Clínic Barcelona, 08036 Barcelona, Spain
7
Department of Radiation Oncology, Hospital Clínic Barcelona, 08036 Barcelona, Spain
8
Department of Medical Oncology, Hospital Clínic Barcelona, 08036 Barcelona, Spain
9
Radiology Department, Hospital Clínic Barcelona, 08036 Barcelona, Spain
10
Gynecologic Oncology and Minimally Invasive Gynecologic Surgery Unit, Department of Obstetrics and Gynecology, 12 de Octubre University Hospital, 28041 Madrid, Spain
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Gennaro Cormio
Cancers 2021, 13(4), 846; https://doi.org/10.3390/cancers13040846
Received: 13 December 2020 / Revised: 31 January 2021 / Accepted: 11 February 2021 / Published: 17 February 2021
(This article belongs to the Special Issue Cervical Carcinoma)
Some recently published studies in early-stage cervical cancer patients have shown that minimally invasive surgery (MIS), including laparoscopic and robotic approaches, might offer lower survival rates than classic open surgery. We evaluated the oncological results of a series of patients treated by laparoscopically assisted radical vaginal hysterectomy (LARVH), an infrequently used MIS technique. We included 115 patients with early-stage cervical cancer (IA1 with lymphovascular invasion, IA2, IB1, and IIA < 2 cm; International Federation of Gynecology (FIGO), 2008). The 3- and 4.5-year disease-free survival rates were 96.7% and 93.5%, respectively, and the overall survival was 97.8% and 94.8%, respectively. These survival data are comparable with those reported with the open radical hysterectomy but presented the advantages of MIS. LARVH offers excellent disease control in women with early-stage cervical cancer and can be considered as an adequate MIS alternative to open radical hysterectomy.
Background: Recent evidence indicates that some minimally invasive surgery approaches, such as laparoscopic and robotic-assisted radical hysterectomy, offer lower survival rates to patients with early-stage cervical cancer than open radical hysterectomy. We evaluated the oncological results of a different minimally invasive surgery approach, that of laparoscopically assisted radical vaginal hysterectomy (LARVH) in this setting. Methods: From January 2001 to December 2018, patients with early-stage cervical cancer were treated by LARVH. Colpotomy and initial closure of the vagina were performed following the Schauta operation, avoiding manipulation of the tumor. Laparoscopic sentinel lymph node (SLN) biopsy was performed in all cases. Women treated between 2001 and 2011 also underwent pelvic lymphadenectomy. Results: There were 115 patients included. Intraoperative complications occurred in nine patients (7.8%). After a median follow-up of 87.8 months (range 1–216), seven women (6%) presented recurrence. Four women died (mortality rate 3.4%). The 3- and 4.5-year disease-free survival rates were 96.7% and 93.5%, respectively, and the overall survival was 97.8% and 94.8%, respectively. Conclusion: LARVH offers excellent disease-free and overall survival in women with early-stage cervical cancer and can be considered as an adequate minimally invasive surgery alternative to open radical hysterectomy. View Full-Text
Keywords: cervical cancer; laparoscopically assisted radical vaginal hysterectomy; minimally invasive surgery; laparoscopy/robotic-assisted surgery; radical hysterectomy cervical cancer; laparoscopically assisted radical vaginal hysterectomy; minimally invasive surgery; laparoscopy/robotic-assisted surgery; radical hysterectomy
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MDPI and ACS Style

Torné, A.; Pahisa, J.; Ordi, J.; Fusté, P.; Díaz-Feijóo, B.; Glickman, A.; Paredes, P.; Rovirosa, A.; Gaba, L.; Saco, A.; Nicolau, C.; Carreras, N.; Agustí, N.; Vidal-Sicart, S.; Gil-Ibáñez, B.; del Pino, M. Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery? Cancers 2021, 13, 846. https://doi.org/10.3390/cancers13040846

AMA Style

Torné A, Pahisa J, Ordi J, Fusté P, Díaz-Feijóo B, Glickman A, Paredes P, Rovirosa A, Gaba L, Saco A, Nicolau C, Carreras N, Agustí N, Vidal-Sicart S, Gil-Ibáñez B, del Pino M. Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery? Cancers. 2021; 13(4):846. https://doi.org/10.3390/cancers13040846

Chicago/Turabian Style

Torné, Aureli, Jaume Pahisa, Jaume Ordi, Pere Fusté, Berta Díaz-Feijóo, Ariel Glickman, Pilar Paredes, Angels Rovirosa, Lydia Gaba, Adela Saco, Carlos Nicolau, Núria Carreras, Núria Agustí, Sergi Vidal-Sicart, Blanca Gil-Ibáñez, and Marta del Pino. 2021. "Oncological Results of Laparoscopically Assisted Radical Vaginal Hysterectomy in Early-Stage Cervical Cancer: Should We Really Abandon Minimally Invasive Surgery?" Cancers 13, no. 4: 846. https://doi.org/10.3390/cancers13040846

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