TY - JOUR
T1 - Simple hysterectomy versus radical hysterectomy in early-stage cervical cancer: A systematic review and meta-analysis
AU - Taliento, C.
AU - Scutiero, G.
AU - Arcieri, M.
AU - Pellecchia, G.
AU - Tius, V.
AU - Bogani, G.
AU - Petrillo, M.
AU - Pavone, M.
AU - Bizzarri, Nicolo'
AU - Driul, L.
AU - Greco, P.
AU - Scambia, G.
AU - Restaino, S.
AU - Vizzielli, G.
PY - 2024
Y1 - 2024
N2 - 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: 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: 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: 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.
AB - 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: 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: 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: 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.
KW - Early-stage cervical cancer
KW - LESSER trial
KW - Meta-analysis
KW - Radical hysterectomy
KW - SHAPE trial
KW - Simple hysteretomy
KW - Early-stage cervical cancer
KW - LESSER trial
KW - Meta-analysis
KW - Radical hysterectomy
KW - SHAPE trial
KW - Simple hysteretomy
UR - https://publicatt.unicatt.it/handle/10807/324957
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85187578403&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85187578403&origin=inward
U2 - 10.1016/j.ejso.2024.108252
DO - 10.1016/j.ejso.2024.108252
M3 - Article
SN - 0748-7983
VL - 50
SP - 108252
EP - 108252
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 4
ER -
