Annals of Surgical Oncology

, Volume 23, Issue 7, pp 2176–2182 | Cite as

Type B versus Type C Radical Hysterectomy After Neoadjuvant Chemotherapy in Locally Advanced Cervical Carcinoma: A Propensity-Matched Analysis

  • Pierluigi Benedetti Panici
  • Violante Di Donato
  • Innocenza Palaia
  • Virginia Sibilla Visentin
  • Claudia Marchetti
  • Giorgia Perniola
  • Angela Musella
  • Maria Luisa Gasparri
  • Francesca Lecce
  • Ilaria Sabatucci
  • Marco Monti
  • Ludovico Muzii
Gynecologic Oncology
  • 289 Downloads

Abstract

Objective

The aim of this study was to evaluate the feasibility and safety of type B radical hysterectomy (RH) in the management of patients affected by locally advanced cervical cancer with favorable prognostic factors (tumor diameter <40 mm, negative nodes, or lymphovascular space involvement) and clinical response to neoadjuvant chemotherapy (NACT).

Methods

The data of women undergoing platinum-based NACT followed by RH plus bilateral systematic pelvic lymphadenectomy were collected. Patients undergoing type B RH (Group A) were compared with those undergoing type C RH (Group B); a propensity-matched comparison (1:1) was carried out to minimize selection biases. Postoperative complications were reported and 5-year survival outcomes were assessed using the Kaplan–Meier model.

Results

Thirty-six node-negative patients undergoing type B RH (Group A) were compared with 36 propensity-matched patients undergoing type C RH (Group B). The bladder dysfunction rate was significantly lower in Group A compared with Group B (13.9 vs. 69.4 %; p < 0.0001), and no statistically significant difference in 5-year overall survival (OS) and disease-free survival (DFS) between groups was reported (OS 93.0 vs. 96.7 %, p = 0.42; DFS 88.6 and 85.5 %, p = 0.77).

Conclusions

Type B RH after NACT in well-selected patients is a safe procedure that upholds the results of type C, reducing operative time and late postoperative morbidity, without detrimental effect on survival. Further prospective trials are warranted to confirm our results on a large scale.

Keywords

Overall Survival Cervical Cancer Propensity Score Radical Hysterectomy Favorable Prognostic Factor 

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Pierluigi Benedetti Panici
    • 1
  • Violante Di Donato
    • 1
  • Innocenza Palaia
    • 1
  • Virginia Sibilla Visentin
    • 1
  • Claudia Marchetti
    • 1
  • Giorgia Perniola
    • 1
  • Angela Musella
    • 1
  • Maria Luisa Gasparri
    • 1
  • Francesca Lecce
    • 1
  • Ilaria Sabatucci
    • 1
  • Marco Monti
    • 1
  • Ludovico Muzii
    • 1
  1. 1.Department of Gynecology, Obstetrics and Urology, Umberto I‘‘Sapienza’’ University of RomeRomeItaly

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