ConCerv: a prospective trial of conservative surgery for low-risk early-stage cervical cancer
العنوان: | ConCerv: a prospective trial of conservative surgery for low-risk early-stage cervical cancer |
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المؤلفون: | Tarinee Manchana, Giovanni Scambia, Bryan Fellman, Preetha Ramalingam, Rene Pareja, Andre Lopes, Audrey Tieko Tsunoda, Julian Di Guilmi, Myriam Perrotta, David F. Cantú-de-León, Lois M. Ramondetta, Pedro T. Ramirez, Gabriel J. Rendón, Robert E. Coleman, David R. Crotzer, Kathleen M. Schmeler, Juan Manuel Carvajal, Michael Frumovitz, José Humberto Tavares Guerreiro Fregnani, Aldo Lopez Blanco, Orla McNally, Martin Riege |
المصدر: | International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 31(10) |
سنة النشر: | 2021 |
مصطلحات موضوعية: | Adult, medicine.medical_specialty, medicine.medical_treatment, Conization, Uterine Cervical Neoplasms, Adenocarcinoma, Conservative Treatment, Hysterectomy, medicine, Humans, Cumulative incidence, Prospective Studies, Stage (cooking), Lymph node, Aged, Retrospective Studies, Cervical cancer, business.industry, Obstetrics and Gynecology, Middle Aged, medicine.disease, Surgery, Dissection, medicine.anatomical_structure, Oncology, Carcinoma, Squamous Cell, Feasibility Studies, Female, Laparoscopy, Lymph, business |
الوصف: | ObjectiveThe objective of the ConCerv Trial was to prospectively evaluate the feasibility of conservative surgery in women with early-stage, low-risk cervical cancer.MethodsFrom April 2010 to March 2019, a prospective, single-arm, multicenter study evaluated conservative surgery in participants from 16 sites in nine countries. Eligibility criteria included: (1) FIGO 2009 stage IA2–IB1 cervical carcinoma; (2) squamous cell (any grade) or adenocarcinoma (grade 1 or 2 only) histology; (3) tumor size <2 cm; (4) no lymphovascular space invasion; (5) depth of invasion <10 mm; (6) negative imaging for metastatic disease; and (7) negative conization margins. Cervical conization was performed to determine eligibility, with one repeat cone permitted. Eligible women desiring fertility preservation underwent a second surgery with pelvic lymph node assessment, consisting of sentinel lymph node biopsy and/or full pelvic lymph node dissection. Those not desiring fertility preservation underwent simple hysterectomy with lymph node assessment. Women who had undergone an ‘inadvertent’ simple hysterectomy with an unexpected post-operative diagnosis of cancer were also eligible if they met the above inclusion criteria and underwent a second surgery with pelvic lymph node dissection only.Results100 evaluable patients were enrolled. Median age at surgery was 38 years (range 23–67). Stage was IA2 (33%) and IB1 (67%). Surgery included conization followed by lymph node assessment in 44 women, conization followed by simple hysterectomy with lymph node assessment in 40 women, and inadvertent simple hysterectomy followed by lymph node dissection in 16 women. Positive lymph nodes were noted in 5 patients (5%). Residual disease in the post-conization hysterectomy specimen was noted in 1/40 patients—that is, an immediate failure rate of 2.5%. Median follow-up was 36.3 months (range 0.0–68.3). Three patients developed recurrent disease within 2 years of surgery—that is, a cumulative incidence of 3.5% (95% CI 0.9% to 9.0%).DiscussionOur prospective data show that select patients with early-stage, low-risk cervical carcinoma may be offered conservative surgery. |
تدمد: | 1525-1438 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e3c3e9241ea91490148c4b94e8a8e83b https://pubmed.ncbi.nlm.nih.gov/34561221 |
Rights: | OPEN |
رقم الانضمام: | edsair.doi.dedup.....e3c3e9241ea91490148c4b94e8a8e83b |
قاعدة البيانات: | OpenAIRE |
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