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Short- and long term outcomes after abdominal radical trachelectomy versus radical hysterectomy for early stage cervical cancer: a systematic review of the literature and meta-analysis

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Abstract

Purpose

Cervical cancer (CC) ranks 2nd for mortality among women of reproductive age in the United States. Abdominal radical trachelectomy (ART) is a fertility sparing approach that has been proposed in women with early stage CC who wish to preserve their fertility. The aim of the present meta-analysis was to evaluate the short- and long-term outcomes of RH vs ART for early stage CC.

Methods

A total of 5 electronic databases were searched for articles published up to December 2018. Prospective and retrospective trials reporting outcomes for women who underwent ART or RH for the management of early stages CC, were considered eligible for inclusion. Statistical meta-analysis was performed using the RevMan 5.3 software.

Results

A total of 5 studies which included 840 women who underwent ART or radical trachelectomy (RH) were included in the present meta-analysis. Among them, 324 underwent ART whereas the remaining 516 had RH. Despite the fact that ART was associated with significantly prolonged operative time compared to RH (840 patients MD 36.82 min, 95% CI 20.15–53.49, p < 0.001), neither 5-year OS nor 5-year DFS were different among the two groups (714 patients OR 1.39, 95% CI 0.53–3.62, p = 0.51 and 682 patients OR 1.08, 95% CI 0.52–2.25, p = 0.84, respectively).

Conclusions

ART is a more complex and time consuming technique, but equally safe compared to RH in terms of oncological outcomes for selected women with early stage CC and allows for more CC survivors of childbearing age to preserve their fertility.

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Authors and Affiliations

  1. Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, Piraeus, Greece

    Anastasia Prodromidou, Christos Iavazzo, Alexandros Fotiou, Victoria Psomiadou, Athanasios Douligeris, Georgios Vorgias & Nikolaos Kalinoglou

  2. Department of Surgical Oncology, Metaxa Memorial Anticancer Hospital, Mpotasi 51, Piraeus, Greece

    Anastasia Prodromidou

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  1. Anastasia Prodromidou
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  2. Christos Iavazzo
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  3. Alexandros Fotiou
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Contributions

AP: data collection and management, data analysis, manuscript writing. CI: protocol/project development, manuscript writing. AF: data collection and manuscript writing. VP: manuscript writing. AD: manuscript writing. GV: protocol/project development, consultation to the manuscript. NK: protocol/project development, consultation to the manuscript.

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Correspondence to Anastasia Prodromidou.

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Prodromidou, A., Iavazzo, C., Fotiou, A. et al. Short- and long term outcomes after abdominal radical trachelectomy versus radical hysterectomy for early stage cervical cancer: a systematic review of the literature and meta-analysis. Arch Gynecol Obstet 300, 25–31 (2019). https://doi.org/10.1007/s00404-019-05176-y

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