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

Fingerprint

Uterine Cervical Neoplasms
Hysterectomy
Vagina
Recurrence
Oculomotor Nerve
Intraoperative Complications
Length of Stay
Multivariate Analysis
Morbidity
Drug Therapy
Wounds and Injuries

Keywords

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

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology
  • Medicine(all)

Cite this

Class III NSRH : Oncological outcome in 170 cervical cancer patients. / Ditto, Antonino; Martinelli, Fabio; Hanozet, Francesco; Reato, Claudio; Solima, Eugenio; Zanaboni, Flavia; Grijuela, Barbara; Carcangiu, Marialuisa; Haeusler, Edward; Raspagliesi, Francesco.

In: Gynecologic Oncology, Vol. 119, No. 2, 11.2010, p. 192-197.

Research output: Contribution to journalArticle

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, vol. 119, no. 2, pp. 192-197. https://doi.org/10.1016/j.ygyno.2010.07.030
Ditto, Antonino ; Martinelli, Fabio ; Hanozet, Francesco ; Reato, Claudio ; Solima, Eugenio ; Zanaboni, Flavia ; Grijuela, Barbara ; Carcangiu, Marialuisa ; Haeusler, Edward ; Raspagliesi, Francesco. / Class III NSRH : Oncological outcome in 170 cervical cancer patients. In: Gynecologic Oncology. 2010 ; Vol. 119, No. 2. pp. 192-197.
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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.",
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T2 - Oncological outcome in 170 cervical cancer patients

AU - Ditto, Antonino

AU - Martinelli, Fabio

AU - Hanozet, Francesco

AU - Reato, Claudio

AU - Solima, Eugenio

AU - Zanaboni, Flavia

AU - Grijuela, Barbara

AU - Carcangiu, Marialuisa

AU - Haeusler, Edward

AU - Raspagliesi, Francesco

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N2 - 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.

AB - 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.

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KW - Local recurrence rate

KW - Nerve-sparing technique

KW - Radical hysterectomy

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