Surveillance of radical hysterectomy for early-stage cervical cancer in the early experienced period of minimally invasive surgery in Japan

Tsuyoshi Ohta, Satoru Nagase, Yosuke Okui, Takayuki Enomoto, Wataru Yamagami, Mikio Mikami, Hideki Tokunaga, Kazuhiko Ino, Kimio Ushijima, Makio Shozu, Hironori Tashiro, Masaki Mandai, Shingo Miyamoto, Ken Ichirou Morishige, Yoshio Yoshida, Kiyoshi Yoshino, Toshiaki Saito, Eiji Kobayashi, Hiroaki Kobayashi, Munetaka TakekumaYoshito Terai, Takuma Fujii, Hiroyuki Kanao, Daisuke Aoki, Hidetaka Katabuchi, Nobuo Yaegashi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The purpose of our study was to conduct a detailed survey of radical hysterectomy in Japanese patients with early-stage cervical cancer, and to compare oncologic outcomes between open and minimally invasive radical hysterectomy. Methods: In Japan during 2015, the medical records of 929 patients with FIGO stage IB1 and IIA disease treated with radical hysterectomy were retrospectively reviewed. We assessed patients’ characteristics, disease-free survival (DFS), overall survival (OS) and prognostic factors for survival. Results: The median patient age was 44 (20–80) years. Most patients (94.4%) had stage IB1 disease. Of the patients who underwent radical hysterectomy, 91.2% underwent open surgery and 8.8% underwent minimally invasive surgery (MIS). The median follow-up period was 40.8 months (range, 0.49–51.1 months). The rate of DFS and OS at 4 years in all patients was 88.3% and 96.4%, respectively. Multivariate analysis identified age (≥ 47), adenocarcinoma histology, tumor size (≥ 2 cm), parametrial invasion, positive lymph node metastasis and institutional accreditation as independent predictors of recurrence, and adenocarcinoma, other cell types, and positive lymph node metastasis as independent predictors of death. Oncologic outcomes in all patients were similar between open and MIS, including DFS and OS. Conclusion: The survival rate of the Japanese patients underwent radical hysterectomy for early-stage cervical cancer was favorable. No significant differences were observed for DFS and OS between open and MIS performed by a limited number of surgeons at a limited number of facilities in Japan. Further investigations are required to identify the appropriate patients might benefit from MIS.

Original languageEnglish
Pages (from-to)2318-2330
Number of pages13
JournalInternational Journal of Clinical Oncology
Volume26
Issue number12
DOIs
Publication statusPublished - 2021 Dec

Keywords

  • Cervical cancer
  • Minimally invasive surgery
  • Open surgery
  • Prognosis
  • Prognostic factors
  • Radical hysterectomy

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

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