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Yuk JS, Cho IC, Lee JH. The Risk of Stress Urinary Incontinence After Hysterectomy for Uterine Fibroids. Int Neurourol J 2023; 27:252-259. [PMID: 38171325 PMCID: PMC10762370 DOI: 10.5213/inj.2346192.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/10/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE We evaluated the relationship between previous hysterectomy for uterine fibroids and subsequent stress urinary incontinence (SUI). METHODS This study analyzed national health insurance data. The hysterectomy group (aged 40 to 59) comprised patients who underwent hysterectomy for uterine fibroids between January 1, 2011 and December 31, 2014, and the control group (aged 40 to 59) comprised patients who visited a medical facility for a checkup during the same time span. One-to-one propensity score matching was performed to balance confounders. SUI was defined as the need for SUI surgery accompanied by a diagnosis code for SUI. RESULTS After matching, 81,373 cases (hysterectomy group) and 81,373 controls (nonhysterectomy group) were enrolled. The mean follow-up period was 7.9 years for the cases and 7.8 years for the controls. The incidence of anti-incontinence surgery was slightly but significantly higher in the cases than in the controls (2.0% vs. 1.7%, P<0.001). Compared to the control group, abdominal hysterectomy significantly increased the likelihood of anti-incontinence surgery both before (hazard ratio [HR], 1.235; 95% confidence interval [CI], 1.116-1.365) and after adjusting for confounders (HR, 1.215; 95% CI, 1.097-1.347). In contrast, laparoscopic hysterectomy, laparoscopic hysterectomy with adnexal surgery, and abdominal hysterectomy with adnexal surgery were not associated with an increased rate of anti-incontinence surgery. The significant association between abdominal hysterectomy and an elevated rate of anti-incontinence surgery persisted even after stratifying patients by age group. CONCLUSION Prior abdominal hysterectomy without adnexal surgery was associated with an increased incidence of subsequent anti-urinary incontinence surgery.
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Affiliation(s)
- Jin-Sung Yuk
- Department of Obstetrics and Gynecology, Inje University Sanggye Paik Hospital, School of Medicine, Inje University, Seoul, Korea
| | - In-Chang Cho
- Department of Urology, National Police Hospital, Seoul, Korea
| | - Jun Ho Lee
- Department of Urology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
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Qiu J, Sun S, Liu Q, Fu J, Huang Y, Hua K. A comparison of concurrent chemoradiotherapy and radical surgery in patients with specific locally advanced cervical cancer (stage IB3, IIA2, IIICr): trial protocol for a randomized controlled study (C-CRAL trial). J Gynecol Oncol 2023; 34:e64. [PMID: 37350146 PMCID: PMC10482577 DOI: 10.3802/jgo.2023.34.e64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/20/2023] [Accepted: 04/16/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND At present, clinical dilemma remains to be solved in terms of therapy-choices for specific locally advanced cervical cancer (LACC) patients: 1) Although concurrent chemoradiotherapy (CCRT) is recommended as the first choice for them, many patients, influenced by the Chinese culture, prefer to choose radical surgery (RS) as their primary treatment. The difference between the 2 therapies in improving patient prognosis is still unknown. 2) Laparoscopy has been questioned since the noted Laparoscopic Approach to Cervical Cancer trial. Nevertheless, clinical research on laparoscopic surgery under the strict tumor-free principle is still underway globally, therefore whether laparoscopic surgery can be used for specific LACC is also an urgent issue to be explored. METHODS A multi-center, randomized controlled study is designed to investigate the effect of different treatment strategies on the prognosis and quality of life (QoL) in patients with specific locally LACC. A total of 402 patients will be enrolled over a period of 3 years. Eligible patients will be randomized (3:1) to either RS group or CCRT group. Patients assigned to RS group will be randomized (1:2) to the abdominal RS group or laparoscopic RS group. All patients will then be followed-up for 5 years. The primary end point is the 2-year progression-free survival (PFS). The secondary end points include 5-year PFS, 2-year overall survival (OS), 5-year OS, adverse events caused by RS or CCRT and QoL. TRIAL REGISTRATION Chinese Clinical Trial Registry Identifier: ChiCTR2000041315.
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Affiliation(s)
- Junjun Qiu
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Shugen Sun
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qinqin Liu
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jie Fu
- Department of Radiation Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yan Huang
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Keqin Hua
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
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Liang X, He H, Li Y, Chen S, Zhao J, Yang B, Lin H, Zeng H, Wei L, Yang J, Fan J. An optimized robotic surgical technique for cervical cancer: investigating whether the use of the pulling robotic arm has better surgical outcomes. Front Oncol 2023; 13:1159081. [PMID: 37483489 PMCID: PMC10358761 DOI: 10.3389/fonc.2023.1159081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 06/02/2023] [Indexed: 07/25/2023] Open
Abstract
Objective The evidence for adopting the 3rd robotic arm (RA) called the pulling RA rather than a uterine manipulator to manipulate the uterus in the robotic radical hysterectomy (RRH) for cervical cancer is still limited. We present a single-center retrospective experience comparing using the pulling RA to replace a uterine manipulator vs. using a uterine manipulator to manipulate the uterus in RRH. Methods 106 patients diagnosed with IA, IB1-IB2 and IIA1 cervical cancer were retrospectively included for intraoperative and postoperative parameters analysis. 50 patients received RRH by adopting the pulling RA instead of a uterine manipulator to pull the uterus (3-RA RRH group), and another 56 patients were performed RRH with a uterine manipulator (2-RA RRH group). RRH with the pulling RA consisted of a camera arm, 3 RAs including a pulling RA, and 2 conventional assistant arms (3-RA RRH group). In comparison, RRH with a uterine manipulator included 2 RAs and 2 conventional assistant arms (2-RA RRH group). Besides, 3-RA' RRH group was selected from the 25th-50th cases in the 3-RA RRH group based on the learning curve and was compared with the 2-RA RRH group in terms of intraoperative and postoperative parameters. Results The patients' early post-operative complication (≤7 days) (p=0.022) and post-operative anemia (p < 0.001) of the 3-RA RRH were significantly lower than that in the 2-RA RRH group. The results of comparing the 2-RA RRH group with the 3-RA' RRH group were consistent with the aforementioned results, except for the operative time (220.4 vs. 197.4 minutes, p=0.022) and hospital stay (7.8 vs. 8.7 days, p=0.034). The median follow-up in the 3-RA RRH and 2-RA RRH groups was 29 and 50 months till March 2023. The 3-RA RRH and 2-RA RRH groups' recurrence rates were 2% (1/50) and 5.4% (3/56), respectively. The mortality in the 3-RA RRH and 2-RA RRH groups was 2% (1/50) and 3.5% (2/56), respectively. Conclusion Our study suggested that replacing the uterine manipulator via the 3rd RA is viable; the results showed comparable surgical outcomes between the two methods. Thus, 3-RA RRH could be considered a well-executed surgical option in well-selected patients.
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Affiliation(s)
- Xuzhi Liang
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Haijing He
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Yingjin Li
- Department of Glandular Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Sibang Chen
- Department of Gynecology, International Peace Maternal and Child Health Hospital of China Welfare Society, Shanghai, China
| | - Jinche Zhao
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Bing Yang
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Huisi Lin
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Hao Zeng
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Liuyi Wei
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Jiahuang Yang
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Jiangtao Fan
- Department of Gynecology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
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Zhou J, Zhang R, Tang X, Liu S, Jiang X. Urinary retention between nerve-sparing radical hysterectomy and radical hysterectomy for cervical cancer: A meta-analysis. Medicine (Baltimore) 2023; 102:e32985. [PMID: 36862911 PMCID: PMC9981420 DOI: 10.1097/md.0000000000032985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
This study intended to assess the urinary retention between nerve-sparing radical hysterectomy and radical hysterectomy in cervical cancer. Relevant studies were selected from databases of PubMed, Embase, Wanfang, and China National Knowledge Internet with the last report up to January 15, 2022. Hazard ratio (HR) and 95% confidence interval (CI) were chosen as the evaluation index. Heterogeneity was assessed using Cochran Q test and I2 test. Subgroup analysis was conducted based on areas and cancer types (primary and metastatic cancer). A total of 8 articles (retrospective cohort studies) were selected in the meta-analysis. There were significant correlations between nerve-sparing radical hysterectomy and radical hysterectomy in related with urinary retention (HR [95% CI] = 1.78 [1.37, 2.31], P < .001) and (HR [95% CI] = 2.49 [1.43, 4.33], P = .001) of cervical cancer patients. Egger test revealed a significant publication bias (P = .014). Sensitivity analysis via omitting 1 study at each time showed that omission of any study made significant difference (P < .05), indicating reliability and good stability for the analysis. Additionally, there were significant heterogeneities in most subgroups.
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Affiliation(s)
- Jing Zhou
- Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Rong Zhang
- Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Xiaohui Tang
- Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Suwei Liu
- Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China
| | - Xiajuan Jiang
- Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China
- * Correspondence: Xiajuan Jiang, Department of Obstetrics and Gynecology, Daping Hospital, Army Military Medical University, Chongqing, China (e-mail address: )
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Wei WW, Zheng H, Shao P, Chen X, Min YF, Tang B, Sun HT, Chen JM, Shi RX. Can laparoscopic nerve-sparing ultra-radical hysterectomy play a role in locally advanced cervical cancer? A single-center retrospective study. Front Oncol 2022; 12:1003951. [PMID: 36387086 PMCID: PMC9641414 DOI: 10.3389/fonc.2022.1003951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background and objectives The objective of this study is to investigate the outcomes of concurrent platinum-based chemoradiation therapy (CCRT), laparoscopic nerve-sparing ultra-radical hysterectomy (LNSURH), and open radical hysterectomy (ORH) on patients with locally advanced cervical carcinoma (LACC). Methods A single-center retrospective study was conducted on LACC patients who received CCRT, ORH, or LNSURH from January 2011 to December 2019. Data on age, tumor size, overall survival (OS), disease-free survival (DFS), and early and late morbidities were collected. After 24 months of treatment, patients were asked a series of questions about their urinary, bowel, and sexual activities. Early morbidities were defined as those occurring during or within a month of treatment, whereas late morbidities and complications were defined as those occurring a month after treatment. The postoperative complications were classified with reference to the Clavien–Dindo classification (CD) system. Results The Kaplan–Meier curves revealed no significant differences in OS and DFS among the three groups (P = 0.106 for DFS and P = 0.190 for OS). The rates of early complications in the CCRT group were comparable with those in the operated groups (P = 0.46). However, late complications were significantly lower in the ORH and LNSURH groups relative to those in the CCRT group. The scores of urinary and bowel functions were restored to the pretreatment state, although the sexual function scores were not satisfactory. Conclusions The treatments of CCRT, ORH, and LNSURH can be considered options for patients with LACC, as their OS and DFS showed no significant difference. In addition, LNSURH exhibited a lower incidence of late complications and high sexual function scores.
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Affiliation(s)
- Wei-wei Wei
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
| | - Hong Zheng
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
| | - Panqiu Shao
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
| | - Xia Chen
- Department of Reproductive Center, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
| | - Yi-fei Min
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
| | - Bin Tang
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
| | - Hui-ting Sun
- Department of Reproductive Center, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
- *Correspondence: Hui-ting Sun, ; Ji-ming Chen, ; Ru-xia Shi,
| | - Ji-ming Chen
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
- *Correspondence: Hui-ting Sun, ; Ji-ming Chen, ; Ru-xia Shi,
| | - Ru-xia Shi
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
- *Correspondence: Hui-ting Sun, ; Ji-ming Chen, ; Ru-xia Shi,
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Wei WW, Wang H, Zheng H, Chen J, Shi RX. Survival Impacts of Perineural Invasion on Patients Under Different Radical Hysterectomies Due to Early Cervical Cancer. Front Oncol 2022; 12:889862. [PMID: 35574312 PMCID: PMC9103185 DOI: 10.3389/fonc.2022.889862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/04/2022] [Indexed: 12/17/2022] Open
Abstract
Objective Cervical cancer is a common gynecological malignancy. In addition to the open radical hysterectomy (ORH) and laparoscopic radical hysterectomy (LRH), laparoscopic nerve-sparing radical hysterectomy (LNSRH) could be another treatment option since it could preserve urinary, colorectal, and sexual functions. However, LNSRH might result in early cancer metastasis and recurrence due to inadequate tumor resection. Additionally, whether LNSRH should be considered based on perineural invasion (PNI) status remains controversial. To assess different types of hysterectomy on the outcome of early cervical cancer with PIN. Methods A retrospective study was performed in early cervical cancer patients who received ORH, LRH, or LNSRH between January 2012 and December 2019. Age, FIGO cancer stages, histopathological types, tumor size, histological grade, invasion depth, lymph node metastasis, lymphovascular space invasion, and PNI were documented. Disease-free survival (DFS) and overall survival (OS) were recorded. Results A total of 174 patients were included, with 33, 69, and 72 patients received LRH, ORH, and LNSRH, respectively. Twenty-one patients (12.1%) had PNI. DFS (P = 0.000) and OS (P = 0.022) periods were shortened in positive PNI patients than in negative PNI patients (P = 0.000 and 0.022, respectively). In patients with positive PNI, lymph node metastasis, but not the surgery type, was an independent risk factor for DFS and OS (P = 0.000). Conclusion Early cervical cancer patients with PNI had shorter postoperative DFS and OS periods. In these patients, lymph node metastasis, but not the type of hysterectomy, was independently associated with DFS and OS.
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Affiliation(s)
| | | | | | | | - Ru-xia Shi
- *Correspondence: Jiming Chen, ; Ru-xia Shi,
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Retrospective Comparison of Laparoscopic versus Open Radical Hysterectomy for Early-Stage Cervical Cancer in a Single Tertiary Care Institution from Lithuania between 2009 and 2019. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58040553. [PMID: 35454391 PMCID: PMC9031924 DOI: 10.3390/medicina58040553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: A great debate within the academic arena was evoked by the LACC study, giving rise to doubt regarding the oncological outcomes of the laparoscopic approach for early-stage cervical cancer. This encouraged us to conduct a retrospective analysis of CC treatment surgical approaches applied to the patients at tertiary level Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania, between 2009 and 2019. Materials and Methods: The retrospective study was carried out to evaluate the outcomes after 28 laparoscopic and 62 laparotomic radical hysterectomies for early cervical cancer in a single tertiary care institution performed during the period 2009–2019. For statistical analysis of patients’ parameters, SPSS v. 17.0 was applied, together with the Kaplan–Meier method with a long-rank test and the Cox proportional hazard regression model used for bi-variate analysis determining OS outcomes between MIS and open-surgery groups. Results: After computing data with the Cox regression model, there was no significant difference of the 36-months overall survival between laparoscopy and laparotomy groups, as opposed to the LACC study. Conclusions: Our tertiary institution faces a considerable challenge, and we acknowledge the limitations of the study and also feel a responsibility to follow the latest guidelines. Currently, it appears that the most substantial attention should be focused on the cessation of uterine manipulator use as well as laparoscopic technique learning curves.
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Kaida T, Hayashi H, Sato H, Kinoshita S, Matsumoto T, Shiraishi Y, Kitano Y, Higashi T, Imai K, Yamashita YI, Baba H. Assessment for the minimal invasiveness of laparoscopic liver resection by interleukin-6 and thrombospondin-1. World J Hepatol 2022; 14:234-243. [PMID: 35126851 PMCID: PMC8790401 DOI: 10.4254/wjh.v14.i1.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 06/23/2021] [Accepted: 12/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Laparoscopic surgery has been introduced as a minimally invasive technique for the treatment of various field. However, there are few reports that have scientifically investigated the minimally invasive nature of laparoscopic liver resection (LLR).
AIM To investigate whether LLR is scientifically less invasive than open liver resection.
METHODS During December 2011 to April 2015, blood samples were obtained from 30 patients who treated with laparoscopic (n = 10, 33%) or open (n = 20, 67%) partial liver resection for liver tumor. The levels of serum interleukin-6 (IL-6) and plasma thrombospondin-1 (TSP-1) were measured using ELISA kit at four time points including preoperative, immediate after operation, postoperative day 1 (POD1) and POD3. Then, we investigated the impact of the operative approaches during partial hepatectomy on the clinical time course including IL-6 and TSP-1.
RESULTS Serum level of IL-6 on POD1 in laparoscopic hepatectomy was significantly lower than those in open hepatectomy (8.7 vs 30.3 pg/mL, respectively) (P = 0.003). Plasma level of TSP-1 on POD3 in laparoscopic hepatectomy was significantly higher than those in open hepatectomy (1704.0 vs 548.3 ng/mL, respectively) (P = 0.009), and have already recovered to preoperative level in laparoscopic approach. In patients with higher IL-6 Levels on POD1, plasma level of TSP-1 on POD3 was significantly lower than those in patients with lower IL-6 Levels on POD1. Multivariate analysis showed that open approach was the only independent factor related to higher level of IL-6 on POD1 [odds ratio (OR), 7.48; 95% confidence interval (CI): 1.28-63.3; P = 0.02]. Furthermore, the higher level of serum IL-6 on POD1 was significantly associated with lower level of plasm TSP-1 on POD3 (OR, 5.32; 95%CI: 1.08-32.2; P = 0.04) in multivariate analysis.
CONCLUSION In partial hepatectomy, laparoscopic approach might be minimally invasive surgery with less IL-6 production compared to open approach.
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Affiliation(s)
- Takayoshi Kaida
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Hiromitsu Hayashi
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Hiroki Sato
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Shotaro Kinoshita
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Takashi Matsumoto
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Yuta Shiraishi
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Yuki Kitano
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Takaaki Higashi
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Katsunori Imai
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Yo-ichi Yamashita
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Hideo Baba
- Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
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Komatsu H, Okawa M, Hikino K, Iida Y, Osaku D, Kudoh A, Chikumi J, Sato S, Oishi T, Harada T. A simplified procedure of nerve‐sparing radical hysterectomy. J Obstet Gynaecol Res 2022; 48:766-773. [DOI: 10.1111/jog.15154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/22/2021] [Accepted: 01/07/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Hiroaki Komatsu
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Masayo Okawa
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Kohei Hikino
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Yuki Iida
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Daiken Osaku
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Akiko Kudoh
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Jun Chikumi
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Shinya Sato
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Tetsuro Oishi
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
| | - Tasuku Harada
- Department of Obstetrics and Gynecology Tottori University School of Medicine Yonago Tottori Prefecture Japan
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Ceccaroni M, Roviglione G, Garzon S, Bruni F, Uccella S. Author's reply to: Comments on the utilization of Mann-Whitney U test and Kaplan-Meier method. J Gynecol Oncol 2021; 32:e54. [PMID: 33825362 PMCID: PMC8039176 DOI: 10.3802/jgo.2021.32.e54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/13/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Marcello Ceccaroni
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Giovanni Roviglione
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy.
| | - Simone Garzon
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Francesco Bruni
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Stefano Uccella
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
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Xie J, Li L. Comments on the utilization of Mann-Whitney U test and Kaplan-Meier method. J Gynecol Oncol 2021; 32:e46. [PMID: 33825365 PMCID: PMC8039177 DOI: 10.3802/jgo.2021.32.e46] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/29/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jian Xie
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Lang Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
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Klapdor R, Hertel H, Delebinski L, Hillemanns P. Association of preoperative cone biopsy with recurrences after radical hysterectomy. Arch Gynecol Obstet 2021; 305:215-222. [PMID: 34291339 PMCID: PMC8782799 DOI: 10.1007/s00404-021-06145-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/14/2021] [Indexed: 11/24/2022]
Abstract
Objective To evaluate association of preoperative cone biopsy with the probability of recurrent disease after radical hysterectomy for cervical cancer. Methods This is a retrospective single-center study. Patients with cervical cancer stage IA1 with LVSI to IIA2 and squamous, adenosquamous and adenocarcinoma subtype were included. Patients were analyzed for general characteristics and recurrence-free survival (RFS). Results In total, of 480 patients with cervical cancer, 183 patients met the inclusion criteria (117 with laparoscopic and 66 with open surgery). The median tumor diameter was 25.0 mm (range 4.6–70.0 mm) with 66 (36.2%) patients having tumors smaller than 2 cm. During median follow-up of 54.0 months (range 0–166.0 months), the RFS for the laparoscopic cohort was 93.2% and 87.5% at 3 and 4.5 years, and 79.3% for the open cohort after 3 and 4.5 years, respectively. In total, 17 (9.3%) patients developed recurrent disease, 9 (7.3%) after laparoscopic, and 8 (12.1%) after open surgery. No preoperative cone biopsy (OR 9.60, 95% CI 2.14–43.09) as well as tumor diameter > 2 cm (OR 5.39, 95% CI 1.20–24.25) were significantly associated with increased risk for recurrence. In multivariate analysis, only missing preoperative cone biopsy was significantly associated with increased risk for recurrence (OR 5.90, 95% CI 1.11–31.29) Conclusion There appears to be a subgroup of patients (preoperative cone biopsy, tumor diameter < 2 cm) with excellent survival and low risk for recurrence after radical hysterectomy which might benefit from the advantages of laparoscopic surgery.
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Affiliation(s)
- Rüdiger Klapdor
- Department of Gynecology and Obstetrics, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hanover, Germany.
| | - Hermann Hertel
- Department of Gynecology and Obstetrics, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hanover, Germany
| | - Laura Delebinski
- Department of Gynecology and Obstetrics, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hanover, Germany
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hanover, Germany
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