Fertility-Sparing Surgery versus Radical Hysterectomy in Early Cervical Cancer : A Propensity Score Matching Analysis and Noninferiority Study
Llueca, Antoni (University Jaume I (UJI))
Ibañez, Maria Victoria (University Jaume I (UJI))
Torne, Aureli (Hospital Clínic i Provincial de Barcelona)
Gil-Moreno, Antonio 1965- (Vall d'Hebron Institut d'Oncologia)
Martin-Jimenez, Angel (Hospital Universitari Son Llàtzer (Palma de Mallorca, Balears))
Díaz-Feijoo, Berta (Hospital Clínic i Provincial de Barcelona)
Serra Rubert, Anna (University Jaume I (UJI))
Climent, Maria Teresa (University Jaume I (UJI))
Gil-Ibañez, Blanca (Hospital 12 de Octubre (Madrid))
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	Fertility-sparing surgery (FSS) is the treatment of choice for patients with early cervical cancer (ECC) and fertility desire, but survival rates compared to radical hysterectomy (RH) have been scarcely reported. The aim of this study was to analyse the oncological outcomes of FSS compared to a balanced group of standard RH. A retrospective multicentre study of ECC patients who underwent FSS or RH was carried out in 12 tertiary hospitals in Spain between January 2005 and January 2019. The experimental group included patients who underwent a simple and radical trachelectomy, and the control group included patients who underwent RH. Optimal 1:1 propensity score (PS) matching analysis was performed to balance the series. The study included 222 patients with ECC; 111 (50%) were treated with FSS, and 111 (50%) were treated with RH. After PS matching, a total of 38 patients in the FSS group and 38 patients in the RH group were analysed. In both groups, the overall survival (HR 2. 5; CI 0. 89, 7. 41) and recurrence rates (28. 9% in the FSS group vs. 13. 2% in RH group) were similar. The rate of disease-free survival at 5 years was 68. 99% in the FSS group and 88. 01% in the RH group (difference of −19. 02 percentage points; 95% CI −32. 08 to −5. 96 for noninferiority). In the univariate analysis, only tumour size reached statistical significance. FSS offers excellent disease-free and overall survival in women with ECC with fertility desire and is not inferior compared to RH.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Early cervical cancer ; Fertility-sparing surgery ; Fertility preservation treatment ; Minimally invasive surgery ; Radical hysterectomy ; Trachelectomy
Published in:	Journal of personalized medicine, Vol. 12 (june 2022) , ISSN 2075-4426

DOI: 10.3390/jpm12071081
PMID: 35887578

14 p, 1.4 MB

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