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Prognostic Factors and Impact of Minimally Invasive Surgery in Early-stage Neuroendocrine Carcinoma of the Cervix.
J Minim Invasive Gynecol. 2020 Feb 18 [Online ahead of print]JM

Abstract

STUDY OBJECTIVE

To investigate the prognostic factors and impact of minimally invasive surgery (MIS) in surgically treated early-stage high-grade (HG) neuroendocrine cervical carcinoma (NECC).

DESIGN

Retrospective cohort study.

SETTING

Asan Medical Center, Seoul, Korea.

PATIENTS

Patients with International Federation of Obstetrics and Gynecology (2009) stages IB1 to IIA HG NECC.

INTERVENTIONS

All patients underwent radical hysterectomy (RH) with a laparotomy or an MIS approach.

MEASUREMENTS AND MAIN RESULTS

Between 1993 and 2017, 47 patients with International Federation of Obstetrics and Gynecology stages IB1 to IIA1 HG NECC were initially treated with RH. Clinicopathologic variables of patients were retrospectively reviewed from electronic medical records. The median follow-up period was 28.2 months (interquartile range, 17.1-42). Stage IB1 disease was the most common (70.2%). Twenty-nine patients (61.7%) underwent RH by MIS. The overall survival (OS) and disease-free survival (DFS) rates were 63.8% and 38.3%, respectively. Lymph node metastasis and resection margin involvement were significant risk factors for DFS (hazard ratio [HR], 2.227; 95% confidence interval [CI], 1.018-4.871; p =.045 and HR, 6.494; 95% CI, 1.415-29.809; p =.016, respectively) and OS (HR, 3.236; 95% CI, 1.188-8.815; p =.022 and HR, 12.710; 95% CI, 1.128-143.152; p =.040, respectively). The Kaplan-Meier survival curves revealed no significant differences in OS and DFS between the laparotomy and MIS groups (50% vs 72.4% log-rank p =.196, 38.9% vs 37.9% p =.975).

CONCLUSION

Lymph node metastasis and resection margin involvement were poor prognostic factors of survival outcomes in initially surgically treated early-stage HG NECC. No difference was observed in the survival outcomes between the MIS and laparotomy approaches.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do (Dr. Ju-Hyun Kim).Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Gwangjin-gu (Dr. Shim).Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu (Drs. Nam, Lee, Park, D. Y. Kim, Suh, Jong-Hyeok Kim, Y. M. Kim, and Y. T. Kim), Seoul, Korea.Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu (Drs. Nam, Lee, Park, D. Y. Kim, Suh, Jong-Hyeok Kim, Y. M. Kim, and Y. T. Kim), Seoul, Korea.Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu (Drs. Nam, Lee, Park, D. Y. Kim, Suh, Jong-Hyeok Kim, Y. M. Kim, and Y. T. Kim), Seoul, Korea.Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu (Drs. Nam, Lee, Park, D. Y. Kim, Suh, Jong-Hyeok Kim, Y. M. Kim, and Y. T. Kim), Seoul, Korea.. Electronic address: kdyog@amc.seoul.kr.Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu (Drs. Nam, Lee, Park, D. Y. Kim, Suh, Jong-Hyeok Kim, Y. M. Kim, and Y. T. Kim), Seoul, Korea.Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu (Drs. Nam, Lee, Park, D. Y. Kim, Suh, Jong-Hyeok Kim, Y. M. Kim, and Y. T. Kim), Seoul, Korea.Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu (Drs. Nam, Lee, Park, D. Y. Kim, Suh, Jong-Hyeok Kim, Y. M. Kim, and Y. T. Kim), Seoul, Korea.Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu (Drs. Nam, Lee, Park, D. Y. Kim, Suh, Jong-Hyeok Kim, Y. M. Kim, and Y. T. Kim), Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32084588

Citation

Kim, Ju-Hyun, et al. "Prognostic Factors and Impact of Minimally Invasive Surgery in Early-stage Neuroendocrine Carcinoma of the Cervix." Journal of Minimally Invasive Gynecology, 2020.
Kim JH, Shim SH, Nam SH, et al. Prognostic Factors and Impact of Minimally Invasive Surgery in Early-stage Neuroendocrine Carcinoma of the Cervix. J Minim Invasive Gynecol. 2020.
Kim, J. H., Shim, S. H., Nam, S. H., Lee, S. W., Park, J. Y., Kim, D. Y., Suh, D. S., Kim, J. H., Kim, Y. M., & Kim, Y. T. (2020). Prognostic Factors and Impact of Minimally Invasive Surgery in Early-stage Neuroendocrine Carcinoma of the Cervix. Journal of Minimally Invasive Gynecology. https://doi.org/10.1016/j.jmig.2020.02.004
Kim JH, et al. Prognostic Factors and Impact of Minimally Invasive Surgery in Early-stage Neuroendocrine Carcinoma of the Cervix. J Minim Invasive Gynecol. 2020 Feb 18; PubMed PMID: 32084588.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic Factors and Impact of Minimally Invasive Surgery in Early-stage Neuroendocrine Carcinoma of the Cervix. AU - Kim,Ju-Hyun, AU - Shim,Seung-Hyuk, AU - Nam,So-Hyun, AU - Lee,Shin-Wha, AU - Park,Jeong-Yeol, AU - Kim,Dae-Yeon, AU - Suh,Dae-Shik, AU - Kim,Jong-Hyeok, AU - Kim,Yong-Man, AU - Kim,Young-Tak, Y1 - 2020/02/18/ PY - 2019/12/09/received PY - 2020/01/26/revised PY - 2020/02/11/accepted PY - 2020/2/23/pubmed PY - 2020/2/23/medline PY - 2020/2/22/entrez KW - Laparoscopy KW - Prognosis KW - Robotic Surgical Procedures KW - Uterine Cervical Neoplasm JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol N2 - STUDY OBJECTIVE: To investigate the prognostic factors and impact of minimally invasive surgery (MIS) in surgically treated early-stage high-grade (HG) neuroendocrine cervical carcinoma (NECC). DESIGN: Retrospective cohort study. SETTING: Asan Medical Center, Seoul, Korea. PATIENTS: Patients with International Federation of Obstetrics and Gynecology (2009) stages IB1 to IIA HG NECC. INTERVENTIONS: All patients underwent radical hysterectomy (RH) with a laparotomy or an MIS approach. MEASUREMENTS AND MAIN RESULTS: Between 1993 and 2017, 47 patients with International Federation of Obstetrics and Gynecology stages IB1 to IIA1 HG NECC were initially treated with RH. Clinicopathologic variables of patients were retrospectively reviewed from electronic medical records. The median follow-up period was 28.2 months (interquartile range, 17.1-42). Stage IB1 disease was the most common (70.2%). Twenty-nine patients (61.7%) underwent RH by MIS. The overall survival (OS) and disease-free survival (DFS) rates were 63.8% and 38.3%, respectively. Lymph node metastasis and resection margin involvement were significant risk factors for DFS (hazard ratio [HR], 2.227; 95% confidence interval [CI], 1.018-4.871; p =.045 and HR, 6.494; 95% CI, 1.415-29.809; p =.016, respectively) and OS (HR, 3.236; 95% CI, 1.188-8.815; p =.022 and HR, 12.710; 95% CI, 1.128-143.152; p =.040, respectively). The Kaplan-Meier survival curves revealed no significant differences in OS and DFS between the laparotomy and MIS groups (50% vs 72.4% log-rank p =.196, 38.9% vs 37.9% p =.975). CONCLUSION: Lymph node metastasis and resection margin involvement were poor prognostic factors of survival outcomes in initially surgically treated early-stage HG NECC. No difference was observed in the survival outcomes between the MIS and laparotomy approaches. SN - 1553-4669 UR - https://www.unboundmedicine.com/medline/citation/32084588/Prognostic_Factors_and_Impact_of_Minimally_Invasive_Surgery_in_Early_stage_Neuroendocrine_Carcinoma_of_the_Cervix_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-4650(20)30094-7 DB - PRIME DP - Unbound Medicine ER -
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