Class III nerve-sparing radical hysterectomy versus standard class III radical hysterectomy: An observational study

Antonino Ditto, Fabio Martinelli, Flavia Mattana, Claudio Reato, Eugenio Solima, Marialuisa Carcangiu, Edward Haeusler, Luigi Mariani, Francesco Raspagliesi

Research output: Contribution to journalArticle

Abstract

Background: The purpose of this observational study was to evaluate disease-free survival, overall survival, local recurrence rate, and morbidities in patients submitted to class III nerve-sparing radical hysterectomy (NSRH) compared with standard radical hysterectomy (RH) in cervical cancer (CC). This was a comparative study in the context of multimodal therapies. Materials and Methods: We investigated patients with CC admitted to the National Cancer Institute of Milan between January 4, 2001, and September 29, 2009, treated with NSRH. We compared patients operated with RH between March 20, 1980, and December 28, 1995. A total of 496 patients were enrolled. The median follow-up was 93 months (42 and 159 months for the NSRH and RH groups, respectively). Results: The overall number of relapses was 30 out of 185 and 60 out of 311 for NSRH and RH, respectively. Fiveyear disease-free survival estimate was 78.9% (95% confidence interval [CI] 72.0-85.7) in NSRH and 79.8% (95% CI 75.3-84.3) in RH (P = 0.519). Five-year overall survival estimate was 90.8% (95% CI 85.9-95.6) in NSRH and 84.1% (95% CI 8.0-88.3) in RH (P = 0.192). Rates of postoperative serious complications were 9.7% and 19.6% for NSRH and RH, respectively (P = 0.004). Positive pelvic lymph node and vagina status were significant (P <0.01) independent predictors by multivariable analyses. Conclusions: The oncologic results were comparable between NSRH and conventional class III RH in the context of two multimodal treatments. Bladder function and postoperative complications rate are improved by nervesparing technique. The nerve-sparing technique should be considered in all CC patients addressed to surgery because it improves functional outcome and preserves radicality without compromising overall survival.

Original languageEnglish
Pages (from-to)3469-3478
Number of pages10
JournalAnnals of Surgical Oncology
Volume18
Issue number12
DOIs
Publication statusPublished - Nov 2011

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ASJC Scopus subject areas

  • Surgery
  • Oncology

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