Special Issue:
Topic Collection "Minimally Invasive Surgery in Gynecological Oncology"
|
|
|
Surgical approach in early stage cervical cancer: the Asian view point |
Hiroko Machida1, 2, Hiroshi Yoshida1, Kenji Izumi1, Rie Nakajima1, Miwa Yasaka1, Tetsuji Iida1, Masae Ikeda1, Masako Shida1, Takeshi Hirasawa1, Mikio Mikami1, *( ) |
1Department of Obstetrics and Gynecology, Tokai University School of Medicine, Shimokasuya, Isehara, 259-1100 Kanagawa, Japan 2Department of Obstetrics and Gynecology, Toyohashi general hospital, 440-0001 Toyohashi, Japan |
|
|
Abstract
Objective: To examine the current practice of radical hysterectomy for early-stage cervical cancer in Asia after the Laparoscopic Approach to Cervical Cancer (LACC) trial. Methods: A cross-sectional study was conducted in Asia to examine the prevalence and management of women with early-stage cervical cancer. The study was conducted among gynecologic oncologists at leading hospitals in the Asian Society of Gynecologic Oncology Council members. A systematic literature review was performed to examine the association between survival outcomes and surgical approach after the LACC trial. Results: Seven countries participated voluntarily in the study. The incidence, mortality, and centralization of treatment in early-stage cervical cancer were different among the seven countries. The number of specialized centers per population density in Japan was higher than that in the other countries. Minimally invasive surgery (MIS) approach for cervical cancer was common in Korea (56%) and Hong Kong (80-90%), but not in the other countries (2-20%). In the systematic review, there was a significant difference in survival outcomes between MIS and open surgery (recurrence, hazard ratio 1.83, 95% confidence interval 1.27-2.62). MIS without a uterine manipulator or making a vaginal cuff closure produced similar recurrence rates compared with open surgery (MIS without uterine manipulator vs open-surgery: 10.5% vs 10.1%, and MIS with cuff closure vs open-surgery 7.2% vs 10.1%; all P > 0.05). Conclusion: The prevalence of MIS for early-stage cervical cancer varies across Asian regions after the LACC trial. Surgical methods to avoid tumor spillage may be useful for improving survival.
|
Submitted: 15 October 2020
Revised: 16 November 2020
Accepted: 20 November 2020
Published: 15 February 2021
|
*Corresponding Author(s):
Mikio Mikami
E-mail: mmikami@is.icc.u-tokai.ac.jp
|
Cite this article:
Hiroko Machida, Hiroshi Yoshida, Kenji Izumi, Rie Nakajima, Miwa Yasaka, Tetsuji Iida, Masae Ikeda, Masako Shida, Takeshi Hirasawa, Mikio Mikami. Surgical approach in early stage cervical cancer: the Asian view point. European Journal of Gynaecological Oncology, 2021, 42(1): 30-37.
URL:
https://ejgo.imrpress.com/EN/10.31083/j.ejgo.2021.01.2270 OR https://ejgo.imrpress.com/EN/Y2021/V42/I1/30
|
No Suggested Reading articles found! |
|
|
Viewed |
|
|
|
Full text
|
|
|
|
|
Abstract
|
|
|
|
|
Cited |
|
|
|
|
|
Shared |
|
|
|
|
|
Discussed |
|
|
|
|