Is a Vaginectomy Enough or is a Pelvic Exenteration Always Required for Surgical Treatment of Recurrent Cervical Cancer?

  • PDF / 368,544 Bytes
  • 10 Pages / 595.276 x 790.866 pts Page_size
  • 71 Downloads / 196 Views

DOWNLOAD

REPORT


ORIGINAL ARTICLE – GYNECOLOGIC ONCOLOGY

Is a Vaginectomy Enough or is a Pelvic Exenteration Always Required for Surgical Treatment of Recurrent Cervical Cancer? A Propensity-Matched Study Giuseppe Vizzielli, PhD1,5 , Lucia Tortorella, MD1, Carmine Conte, MD1, Vito Chiantera, MD2, Valerio Gallotta, MD1, Nazario Foschi, MD3, Martina Arcieri, MD1, Gabriella Ferrandina, MD1,4, Anna Fagotti, MD1,4, Filiberto Zattoni, MD5, Giovanni Scambia, MD1,4, and Alfredo Ercoli, PhD6 1

Dipartimento Scienze della Salute della Donna e del Bambino e Sanita` Pubblica, Fondazione Policlinico Universitario ‘‘Agostino Gemelli’’ IRCCS, Rome, Italy; 2Division of Gynecologic Oncology, University of Palermo, Palermo, Italy; 3 Division of Urology, Fondazione Policlinico Universitario ‘‘Agostino Gemelli’’ IRCCS, Rome, Italy; 4Dipartimento Scienze della Salute della Donna e del Bambino e Sanita` Pubblica, Universita` Cattolica del Sacro Cuore, Rome, Italy; 5 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Padua, Italy; 6Department of Obstetrics and Gynecology, University of Messina, Messina, Italy

ABSTRACT Purpose. Reporting the perioperative and survival outcomes of vaginectomy with respect to a matched series of pelvic exenteration (PE) in women with isolated recurrent cervical cancer. Methods. The records of vaginal recurrent cervical cancer patients admitted at Fondazione Policlinico ‘‘Agostino Gemelli’’ IRCCS in Rome from January 2010 to June 2019 were retrospectively analyzed. A propensity-matched score analysis was performed by age, clinical stage, disease-free interval, and R0 resection. Postsurgical complications and survival rates were evaluated. Results. Fifteen women underwent vaginectomy, and 30 patients were submitted to PE. No statistical differences were observed between the two groups at baseline characteristics. The vaginectomy procedures were successfully performed in all women, and no case required conversion

Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-09207-w) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 14 April 2020 Accepted: 17 September 2020 G. Vizzielli, PhD e-mail: [email protected]; [email protected]

to PE. Moreover, a higher rate of major postoperative complications after PE with respect to vaginectomy (p = 0.027) was recorded. Among them, three women required reoperation within 30 postoperative days, and four experienced two or more complications. Twenty-five (55.6%) women experienced recurrence: 8 of 25 (32.0%) in the vaginectomy group, and 17 of 25 (68%) in the PE group, with a median progression-free survival of 20 months and 13 months, respectively (p = 0.169). In total, 5 of 15 (33.3%) died of disease in the vaginectomy group and 13/30 (43.3%) in the PE group, with a median overall survival of 39 and 18 months for vaginectomy and PE, respectively (p = 0.161). Conclusions. The vaginectomy seems to all