J 2015

Oncological Outcomes of Nerve-Sparing Radical Hysterectomy for Cervical Cancer: A Systematic Review

BASARAN, Derman, Ladislav DUŠEK, Ondřej MÁJEK and David CIBULA

Basic information

Original name

Oncological Outcomes of Nerve-Sparing Radical Hysterectomy for Cervical Cancer: A Systematic Review

Authors

BASARAN, Derman (792 Turkey), Ladislav DUŠEK (203 Czech Republic, guarantor, belonging to the institution), Ondřej MÁJEK (203 Czech Republic, belonging to the institution) and David CIBULA (203 Czech Republic)

Edition

Annals of Surgical Oncology, New York, Springer, 2015, 1068-9265

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 3.655

RIV identification code

RIV/00216224:14110/15:00083872

Organization unit

Faculty of Medicine

DOI

UT WoS

000359425000033

Keywords in English

cancer adjuvant therapy; cancer recurrence; follow up; human; intermethod comparison; nerve sparing radical hysterectomy; nuclear magnetic resonance imaging; outcome assessment; radical hysterectomy; Review; systematic review; uterine cervix cancer

Tags

Tags

International impact, Reviewed
Změněno: 17/9/2015 15:02, Soňa Böhmová

Abstract

V originále

This study aimed to review the oncologic outcomes of nerve-sparing radical hysterectomy (NSRH) in cervical cancer and to compare them with those of standard conventional radical hysterectomy (CRH). A search of the MEDLINE (Ovid), EMBASE (Ovid), and Cochrane Central Register of Controlled Trials (CENTRAL) databases for studies published to March 3, 2014 was performed using the search term "nerve sparing or radical hysterectomy and cervical cancer." The main outcome measure was the recurrence rate after NSRH. The hazard ratio for recurrence was used to compare NSRH and CRH. A total of 21 studies reported data on oncologic outcomes of NSRH. The recurrence rate after NSRH was reported to be 0 to 19.6 %. Of the 21 studies, 10 comparing outcomes between NSRH and CRH were assessed for their eligibility to be included in a meta-analysis. However, the scarcity and heterogeneity of effect estimates in these comparison trials precluded performance of a meta-analysis. The results showed that the evidence addressing the oncologic safety of NSRH over that of CRH in cervical cancer is neither adequate nor statistically relevant. A properly designed, prospective randomized noninferiority trial is needed to assess the oncologic outcomes of NSRH before this surgical approach is adopted as the standard of care for patients with tumors that have unfavorable prognostic features. Until then, NSRH should be considered primarily for patients with small tumors due to the very low risk of parametrial and lymph node involvement, with maximum benefit conferred to the patient from autonomic nerve preservation without any requirement for adjuvant treatment.