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Predictive factors of severe perioperative morbidity of radical hysterectomy with lymphadenectomy in early-stage cervical cancer: A French prospective multicentric cohort of 248 patients

Balaya, V. et al.

European journal of surgical oncology. Volume 45:Issue 4 (2019); pp 650-658 -- Elsevier Ltd

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  • Title:
    Predictive factors of severe perioperative morbidity of radical hysterectomy with lymphadenectomy in early-stage cervical cancer: A French prospective multicentric cohort of 248 patients
  • Author: Balaya, V.;
    Mathevet, P.;
    Magaud, L.;
    Delomenie, M.;
    Bonsang-Kitzis, H.;
    Ngô, C.;
    Huchon, C.;
    Bats, A.S.;
    Lecuru, F.
  • Found In: European journal of surgical oncology. Volume 45:Issue 4 (2019); pp 650-658
  • Journal Title: European journal of surgical oncology
  • Subjects: Cancer--Chirurgie--Périodiques; Cancérologie--Périodiques; Medical Oncology--Periodicals; Neoplasms--surgery--Periodicals; Electronic journals--Medicine; Electronic journals--Sciences; Cancer--Surgery--Periodicals; Electronic journals; Oncology--Periodicals; Chirurgie (geneeskunde); Oncologie; Cervical cancer--Surgery--Morbidity--Complications--Radical hysterectomy; Dewey: 616.994059005
  • Rights: legaldeposit
  • Publication Details: Elsevier Ltd
  • Abstract: Abstract: Objective:

    The purpose of this study was to assess the postoperative morbidity after radical hysterectomy (RH) for early-stage cervical cancer and to determine risk factors of severe perioperative morbidity.

    Methods:

    Data of two prospective trials on sentinel node biopsy for cervical cancer (SENTICOL I & II) were analysed. Patients having a radical hysterectomy were included between 2005 and 2012 from 25 French oncologic centers. Postoperative complications were prospectively recorded in a pre-specified analysis.

    Results:

    248 patients met the inclusion criteria. The median age was 44.5 years [25–85]. 88.7% of patients had a stage IB1 disease. There were 71.4% epidermoid carcinomas and 25% adenocarcinomas. 125 patients (50.4%) had a laparoscopic-assisted vaginal RH, 88 patients (35.5%) had a total laparoscopic RH, 26 patients (10.5%) had an open RH and 9 patients (3.6%) had a robotic-assisted RH. Sixteen patients (6.4%) had intraoperative complications. On a multivariate analysis, intraoperative complications were significantly associated with BMI >30 kg/m 2 . The urinary, lymphovascular and neurologic complications rates were respectively 34.3%, 20.6% and 19.8%. 31 patients (12.5%) had severe postoperative complications (Clavien-Dindo ≥ 3 or CTCAE ≥ 3). On multivariate analysis, severe postoperative complications were associated with parametrial involvement, preoperative brachytherapy and inclusion in low surgical skills center.

    Conclusions:

    This study based on prospective data showed that RH has low severe postoperative complications. The main complications were urinary infections and lower limb lymphedema. Patients with early-stage cervical cancer should be referred to expert center to ensure best surgical outcomes.


  • Identifier: System Number: LDEAvdc_100079242845.0x000001; Journal ISSN: 0748-7983; 10.1016/j.ejso.2018.10.057
  • Publication Date: 2019
  • Physical Description: Electronic
  • Shelfmark(s): ELD Digital store

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