Nerve-sparing versus non-nerve-sparing radical hysterectomy: Surgical and long-term oncological outcomes

Antonio Gil-Moreno, Melchor Carbonell-Socias, Sabina Salicrú, Melissa Bradbury, Ángel García, Ramona Vergés, Oriol Puig Puig, José Luís Sánchez-Iglesias, Silvia Cabrera-Díaz, Javier De La Torre, Natalia R. Gómez-Hidalgo, Assumpció Pérez-Benavente, Berta Díaz-Feijoo

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Abstract

Copyright: Gil-Moreno et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License 3.0 (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Objectives: There are controversies regarding the long-term oncological safety of preservation of pelvic innervation during radical hysterectomy (RH). This study aimed to analyze the feasibility and safety of nerve-sparing radical hysterectomy (NSRH) for cervical cancer compared with non-NSRH following 17 years of experience in a tertiary cancer referral center. Materials and Methods: Between May 1999 and June 2016, all patients who underwent RH for cervical cancer were followed-up prospectively. Comparison analyses regarding surgical outcomes, complications, overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) were performed between patients treated with NSRH and non-NSRH. Results: A total of 188 patients were included (113 non-NSRH and 75 NSRH). The median follow-up was 112 months. Estimated blood loss and hospital stay were all significantly lower in the NSRH group. Overall intraoperative complication rate (p = 0.02) and need for transfusion (p = 0.016) were lower in the NSRH group. There were no differences in the median operation time, OS, DFS, CSS, or recurrence rates between the NSRH and non-NSRH group. Conclusions: Our study provides a wide perspective on the developments of nerve-sparing procedures for the management of women with early-stage cervical cancer. Our results suggest that NSRH is a feasible and safe procedure, with reduced morbidity outcomes.
Original languageEnglish
Pages (from-to)4598-4608
JournalOncotarget
Volume10
Publication statusPublished - 1 Jul 2019

Keywords

  • Cervical cancer
  • Morbidity
  • Recurrence
  • Surgical treatment
  • Survival

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    Gil-Moreno, A., Carbonell-Socias, M., Salicrú, S., Bradbury, M., García, Á., Vergés, R., Puig, O. P., Sánchez-Iglesias, J. L., Cabrera-Díaz, S., De La Torre, J., Gómez-Hidalgo, N. R., Pérez-Benavente, A., & Díaz-Feijoo, B. (2019). Nerve-sparing versus non-nerve-sparing radical hysterectomy: Surgical and long-term oncological outcomes. Oncotarget, 10, 4598-4608.