Simple hysterectomy versus radical hysterectomy in early-stage cervical cancer: A systematic review and meta-analysis.

Early-stage cervical cancer LESSER trial Meta-analysis Radical hysterectomy SHAPE trial Simple hysteretomy

Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356

Informations de publication

Date de publication:
05 Mar 2024
Historique:
received: 03 02 2024
revised: 29 02 2024
accepted: 04 03 2024
medline: 13 3 2024
pubmed: 13 3 2024
entrez: 12 3 2024
Statut: aheadofprint

Résumé

This systematic review (SR) and meta-analysis aims to compare the surgery-related results and oncological outcomes between SH and RH in patients with early-stage cervical cancer. We systematically searched databases including PubMed, Embase and Cochrane to collect studies that compared oncological and surgery-related outcomes between SH and RH groups in patients with stage IA2 and IB1 cervical cancer. A random-effect model calculated the weighted average difference of each primary outcome via Review Manager V.5.4. Seven studies comprising 6977 patients were included into our study. For oncological outcomes, we found no statistical difference in recurrence rate [OR = 0.88; 95% CI (0.50, 1.57); P = 0.68] and Overall Survival (OS) [OR = 1.23; 95% CI (0.69, 2.19), P = 0.48]. No difference was detected in the prevalence of positive LVSI and lymph nodes metastasis between the two groups. Concerning surgery-related outcomes, the comprehensive effects revealed that the bladder injury [OR = 0.28; 95% CI (0.08, 0.94), P = 0.04] and bladder disfunction [OR = 0.10; 95% CI (0.02, 0.53), P = 0.007] of the RH group were higher compared to the SH group. This meta-analysis suggested there are no significant differences in terms of both recurrence rate and overall survival among patients with stage IA2-IB1 cervical cancer undergoing SH or RH, while the SH group has better surgery-related outcomes. These data confirm the need to narrow the indication for RH in early-stage cervical cancer.

Sections du résumé

BACKGROUND BACKGROUND
This systematic review (SR) and meta-analysis aims to compare the surgery-related results and oncological outcomes between SH and RH in patients with early-stage cervical cancer.
METHOD METHODS
We systematically searched databases including PubMed, Embase and Cochrane to collect studies that compared oncological and surgery-related outcomes between SH and RH groups in patients with stage IA2 and IB1 cervical cancer. A random-effect model calculated the weighted average difference of each primary outcome via Review Manager V.5.4.
RESULT RESULTS
Seven studies comprising 6977 patients were included into our study. For oncological outcomes, we found no statistical difference in recurrence rate [OR = 0.88; 95% CI (0.50, 1.57); P = 0.68] and Overall Survival (OS) [OR = 1.23; 95% CI (0.69, 2.19), P = 0.48]. No difference was detected in the prevalence of positive LVSI and lymph nodes metastasis between the two groups. Concerning surgery-related outcomes, the comprehensive effects revealed that the bladder injury [OR = 0.28; 95% CI (0.08, 0.94), P = 0.04] and bladder disfunction [OR = 0.10; 95% CI (0.02, 0.53), P = 0.007] of the RH group were higher compared to the SH group.
CONCLUSION CONCLUSIONS
This meta-analysis suggested there are no significant differences in terms of both recurrence rate and overall survival among patients with stage IA2-IB1 cervical cancer undergoing SH or RH, while the SH group has better surgery-related outcomes. These data confirm the need to narrow the indication for RH in early-stage cervical cancer.

Identifiants

DOI: 10.1016/j.ejso.2024.108252 PMID: 38471373
pubmed: 38471373
pii: S0748-7983(24)00304-4
doi: 10.1016/j.ejso.2024.108252
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

108252

Informations de copyright

© 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Auteurs

C Taliento (C)

Department of Medical Sciences, Obstetrics and Gynecology Unit, University of Ferrara, Italy; Department of Development and Regeneration - Woman and Child, KU Leuven, Leuven, Belgium.

G Scutiero (G)

Department of Medical Sciences, Obstetrics and Gynecology Unit, University of Ferrara, Italy.

M Arcieri (M)

Clinic of Obstetrics and Gynecology, "Santa Maria Della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Medical Area Department (DAME), University of Udine, Udine, Italy.

G Pellecchia (G)

Clinic of Obstetrics and Gynecology, "Santa Maria Della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Medical Area Department (DAME), University of Udine, Udine, Italy.

V Tius (V)

Clinic of Obstetrics and Gynecology, "Santa Maria Della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Medical Area Department (DAME), University of Udine, Udine, Italy.

G Bogani (G)

Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy.

M Petrillo (M)

Department of Obstetrics and Gynecology. University of Sassari, Sassari, Italy.

M Pavone (M)

Gynecologic Oncology Unit, Fondazione "Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy; Institute of Image-Guided Surgery, IHU Strasbourg, Strasbourg, France.

N Bizzarri (N)

Gynecologic Oncology Unit, Fondazione "Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy.

L Driul (L)

Clinic of Obstetrics and Gynecology, "Santa Maria Della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Medical Area Department (DAME), University of Udine, Udine, Italy.

P Greco (P)

Department of Medical Sciences, Obstetrics and Gynecology Unit, University of Ferrara, Italy.

G Scambia (G)

Gynecologic Oncology Unit, Fondazione "Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy.

S Restaino (S)

Clinic of Obstetrics and Gynecology, "Santa Maria Della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Department of Obstetrics and Gynecology. University of Sassari, Sassari, Italy. Electronic address: s.restaino@studenti.uniss.it.

G Vizzielli (G)

Clinic of Obstetrics and Gynecology, "Santa Maria Della Misericordia" University Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; Medical Area Department (DAME), University of Udine, Udine, Italy.

Classifications MeSH