Class III NSRH: Oncological outcome in 170 cervical cancer patients

Antonino Ditto, Fabio Martinelli, Francesco Hanozet, Claudio Reato, Eugenio Solima, Flavia Zanaboni, Barbara Grijuela, Marialuisa Carcangiu, Edward Haeusler, Francesco Raspagliesi

Research output: Contribution to journalArticle

Abstract

Objective: To analyze local recurrence rate (LRR), morbidities and oncologic outcome of class III nerve-sparing radical hysterectomy. Patients and methods: 170 consecutive class III NSRH cases were performed. Nineteen patients were addressed directly to surgery whilst neoadjuvant chemotherapy was administered in 151 patients. The majority of patients had SCC (75%). The median follow-up was 31 months. Results: The mean age was 50 [27-78] years. Mean post-operative hospital stay was 7 [3-16] days. 2 intraoperative complications occurred. Operating time and blood loss was similar to the state-of-the-art of conventional radical hysterectomy. Overall G3-4 complication rate was 8.2 % (14/170). Early G3-4 complication rate was 3.5% (6/170). Late G3-4 complication rate was: 4.7%. (8/170). Positive pelvic nodes were noted in 31 patients (18.2%). Vagina and parametrial involvement were present in 38 (22%) and 27 (15.8%) patients, respectively. LRR was 10% (17/170). The sites of relapse were: 12 pelvic, 5 vaginal. There were 9 patients DOD. The 2-year and 5-year DFS rates were 89% and 81%, respectively. Univariate and multivariate analysis identified vagina involvement and postoperative treatment as significant prognostic factors. Conclusions: The oncologic results of NSRH were similar to the state-of-the-art of conventional radical hysterectomy. Two years DFS in relation to FIGO stage of disease was 92.3, 89.2 and 86.1 % respectively for IB1, IB2, IIB comparable to literature data. The early and late complications rate related to autonomic injury was significantly lower. The nerve-sparing technique should be considered in all cervical cancer patients addressed to surgery.

Original languageEnglish
Pages (from-to)192-197
Number of pages6
JournalGynecologic Oncology
Volume119
Issue number2
DOIs
Publication statusPublished - Nov 2010

Keywords

  • Cervical cancer
  • DFS
  • Local recurrence rate
  • Nerve-sparing technique
  • Radical hysterectomy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology
  • Medicine(all)

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    Ditto, A., Martinelli, F., Hanozet, F., Reato, C., Solima, E., Zanaboni, F., Grijuela, B., Carcangiu, M., Haeusler, E., & Raspagliesi, F. (2010). Class III NSRH: Oncological outcome in 170 cervical cancer patients. Gynecologic Oncology, 119(2), 192-197. https://doi.org/10.1016/j.ygyno.2010.07.030