Gil-Moreno Antonio, Carbonell-Socias Melchor, Salicrú Sabina, Bradbury Melissa, García Ángel, Vergés Ramona, Puig Oriol Puig, Sánchez-Iglesias José Luís, Cabrera-Díaz Silvia, de la Torre Javier, Gómez-Hidalgo Natalia R, Pérez-Benavente Assumpció, Díaz-Feijoo Berta
Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.
Department of Pathology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.
Oncotarget. 2019 Jul 16;10(44):4598-4608. doi: 10.18632/oncotarget.27078.
There are controversies regarding the long-term oncological safety of preservation of pelvic innervation during radical hysterectomy (RH). This study aimed to analyze the feasibility and safety of nerve-sparing radical hysterectomy (NSRH) for cervical cancer compared with non-NSRH following 17 years of experience in a tertiary cancer referral center.
Between May 1999 and June 2016, all patients who underwent RH for cervical cancer were followed-up prospectively. Comparison analyses regarding surgical outcomes, complications, overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) were performed between patients treated with NSRH and non-NSRH.
A total of 188 patients were included (113 non-NSRH and 75 NSRH). The median follow-up was 112 months. Estimated blood loss and hospital stay were all significantly lower in the NSRH group. Overall intraoperative complication rate ( = 0.02) and need for transfusion ( = 0.016) were lower in the NSRH group. There were no differences in the median operation time, OS, DFS, CSS, or recurrence rates between the NSRH and non-NSRH group.
Our study provides a wide perspective on the developments of nerve-sparing procedures for the management of women with early-stage cervical cancer. Our results suggest that NSRH is a feasible and safe procedure, with reduced morbidity outcomes.
关于根治性子宫切除术（RH）中保留盆腔神经支配的长期肿瘤学安全性存在争议。本研究旨在分析在一家三级癌症转诊中心积累17年经验后，与非保留神经的根治性子宫切除术（NSRH）相比，保留神经的根治性子宫切除术（NSRH）治疗宫颈癌的可行性和安全性。
1999年5月至2016年6月期间，对所有接受宫颈癌RH的患者进行前瞻性随访。对接受NSRH和非NSRH治疗的患者进行手术结果、并发症、总生存期（OS）、无病生存期（DFS）和癌症特异性生存期（CSS）的比较分析。
共纳入188例患者（113例非NSRH和75例NSRH）。中位随访时间为112个月。NSRH组的估计失血量和住院时间均显著更低。NSRH组的总体术中并发症发生率（P = 0.02）和输血需求（P = 0.016）更低。NSRH组和非NSRH组在中位手术时间、OS、DFS、CSS或复发率方面无差异。
我们的研究为早期宫颈癌女性患者保留神经手术的发展提供了广阔视角。我们的结果表明，NSRH是一种可行且安全的手术，其发病率结果更低。
