[ad_1]
Nov. 1 (UPI) – Early-stage cervical cancer patients who undergo a minimally invasive hysterectomy.
Researchers "recommending the use of open surgery for cervical cancer" based on the epidemiologic study published Wednesday in the New England Journal of Medicine.
And researchers examining a phase 3 trial, published in the same issue of the New England Journal of Medicine, also supports only open surgery.
Researchers from Harvard Medical School, MD Anderson Cancer Center, University of Wisconsin School of Medicine and Public Health and the Herbert Irving Comprehensive Cancer Center at Columbia University.
"Dr. Amanda N. Fader, a professor in the Department of Gynecology and Obstetrics at the Department of Gynecology and Obstetrics at a major blow. Johns Hopkins School of Medicine, wrote in an accompanying editorial in the journal. "Although the data is alarming, select patient subgroups may still benefit from a less invasive approach.
Cervical cancer is due to the abnormal growth of cells in the cervix that has the ability to invade or spread to other parts of the body.
It is the fourth most frequently diagnosed cancer and the fourth leading cause of cancer-related death in women worldwide. Around 13,240 women will be diagnosed with cervical cancer in the United States this year, according to the American Society of Clinical Oncology.
Current guidelines from the National Comprehensive Cancer Network and European Society of Gynecological Oncology indicate that laparotomy, which is open surgery, or laparoscopy, which is minimally invasive surgery, is an acceptable approach to radical hysterectomy in patients with early-stage cervical cancer.
A hysterectomy is the removal of the uterus, cervix and other parts of the female reproductive system
Since 2006, minimally invasive radical hysterectomy first started to become popular. In 2010, just over a third of radical hysterectomies were performed minimally invasive surgery, but by 2013, nearly 60 percent were performed minimally invasively, researchers noted.
In minimally invasive surgery, the abdomen is inflated with gas and small incisions are made using a camera and long instruments or a robot. Patients sometimes go to the same day as the procedure, which is much shorter than the open surgery.
In the more invasive surgery, there is large laparotomy incision in the middle of the abdomen.
In the epidemiologic study, the risk of death in the United States was 9.1 percent among women undergoing minimally invasive surgery compared to 5.3 percent in the open surgery group. This means women who undergo minimally invasive surgery. 1.65 times more likely to die on this timeframe than if they received open surgery.
"At this point, we would recommend using open surgery to perform a radical hysterectomy for cervical cancer," co-senior author Dr. Shohreh Shahabi, chief of gynecology oncology at Northwestern University's Feinberg School of Medicine and Northwestern Medicine Physician, said a press release on the study.
She noted the results of cervical cancer "and minimally invasive surgery is still a great option for other surgeries and cancers."
"Although based on our findings, we may not be able to explain why surgery may be minimally invasive surgery, where possible minimally invasive surgery may be inadvertently disseminated." Shahabi said.
The study examined data from patients in the National Cancer Database from 2010 to 2013, which includes 70 percent of all new cancer diagnoses in the United States.
A total of 2,461 patients had stage IA2 or IB1 cervical cancer which were treated with a radical hysterectomy. About half of these women had had surgery and half had minimally invasive surgery.
In the other study, 319 patients with a mean age of 46 were assigned to minimally invasive surgery and 31 to undergo open surgery from June 2008 through June 2017 at 33 centers. Among all patients, 91.9 percent, had stage IB1 disease.
Of patients who underwent minimally invasive surgery, 84.4 percent underwent laparoscopy and 15.6 percent robot-assisted surgery. The rate of disease-free survival at 4.5 years was 86 percent with minimally invasive surgery and 96.5 percent with open surgery.
"The strengths of our trial include the fact that it is a prospective, randomized trial evaluation oncologic outcomes of minimally invasive radical hysterectomy," Dr. Pedro T. Ramirez, study leader in the Department of Gynecologic Oncology and Reproductive Medicine at Anderson Mzd. Cancer Center, wrote. "It is a large number of centers throughout the world, and all centers have been required to demonstrate proficiency in minimally invasive surgery.
[ad_2]
Source link
