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Lambaudie E, Bogart E, Le Deley MC, El Hajj H, Gauthier T, Hebert T, Collinet P, Classe JM, Lecuru F, Motton S, Conri V, Ferrer C, Marchal F, Ferron G, Probst A, Jauffret C, Narducci F. The Influence of Surgical Complexity and Center Experience on Postoperative Morbidity After Minimally Invasive Surgery in Gynecologic Oncology: Lessons Learned from the ROBOGYN-1004 Trial. Ann Surg Oncol 2024; 31:4566-4575. [PMID: 38616209 PMCID: PMC11164758 DOI: 10.1245/s10434-024-15265-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 03/22/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND This study was a secondary analysis of the ROBOGYN-1004 trial conducted between 2010 and 2015. The study aimed to identify factors that affect postoperative morbidity after either robot-assisted laparoscopy (RL) or conventional laparoscopy (CL) in gynecologic oncology. METHODS The study used two-level logistic regression analyses to evaluate the prognostic and predictive value of patient, surgery, and center characteristics in predicting severe postoperative morbidity 6 months after surgery. RESULTS This analysis included 368 patients. Severe morbidity occurred in 49 (28 %) of 176 patients who underwent RL versus 41 (21 %) of 192 patients who underwent CL (p = 0.15). In the multivariate analysis, after adjustment for the treatment group (RL vs CL), the risk of severe morbidity increased significantly for patients who had poorer performance status, with an odds ratio (OR) of 1.62 for the 1-point difference in the WHO performance score (95 % CI 1.06-2.47; p = 0.027) and according to the type of surgery (p < 0.001). A focus on complex surgical acts showed significant more morbidity in the RL group than in the CL group at the less experienced centers (OR, 3.31; 95 % CI 1.0-11; p = 0.05) compared with no impact at the experienced centers (OR, 0.87; 95 % CI 0.38-1.99; p = 0.75). CONCLUSION The findings suggest that the center's experience may have an impact on the risk of morbidity for patients undergoing complex robot-assisted surgical procedures.
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Affiliation(s)
| | | | - Marie-Cécile Le Deley
- Oscar Lambret Cancer Center, Lille, France
- Université Paris-Sud, UVSQ, CESP, INSERM, Université Paris-Saclay, Villejuif, France
| | - Houssein El Hajj
- Paoli Calmettes Institute, Marseille, France.
- Oscar Lambret Cancer Center, Lille, France.
| | | | | | | | | | | | | | | | | | - Frederic Marchal
- CRAN, UMR 7039, CNRS Institut de Cancérologie de Lorraine Vandoeuvre les-Nancy, Université de Lorraine, Nancy, France
| | - Gwenael Ferron
- Institut Claudius Regaud Cancer Center-Toulouse, Toulouse, France
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Kissel M, Balaya V, Guani B, Magaud L, Mathevet P, Lécuru F. Impact of preoperative brachytherapy followed by radical hysterectomy in stage IB2 (FIGO 2018) cervical cancer: An analysis of SENTICOL I-II trials. Gynecol Oncol 2023; 170:309-316. [PMID: 36758421 DOI: 10.1016/j.ygyno.2023.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION The goal of this study was to compare the outcomes of preoperative brachytherapy followed by radical surgery versus radical surgery alone in cervical cancer with tumor between 2 and 4 cm (FIGO 2018 IB2). MATERIAL AND METHODS SENTICOL I and SENTICOL II were two French prospective multicentric trials evaluating sentinel node biopsy in early-stage cervical cancer between 2005 and 2012. Preoperative brachytherapy (low-dose rate or pulse-dose rate at the dose of 60Gy) could be performed 6 to 8 weeks prior to the radical hysterectomy, at the discretion of each center. SENTICOL I and SENTICOL II cohorts were retrospectively analysed to compare the outcomes of preoperative brachytherapy or upfront surgery in patients with IB2 cervical tumor. RESULTS A total of 104 patients were included: 55 underwent upfront radical hysterectomy and 49 underwent preoperative brachytherapy followed by radical hysterectomy. Patients with preoperative brachytherapy were more likely to have no residual disease (71.4% vs. 25.5%, p < 0.0001) and to be defined as low risk according to Sedlis criteria (83.3% vs. 51.2%, p < 0.0001). Adjuvant treatments were required less frequently in case of preoperative brachytherapy (14.3% vs. 54.5%, p < 0.0001). Patients with preoperative brachytherapy experienced more postoperative complications grade ≥ 3 (24.5% vs. 9.1%, p = 0.03). Patients with preoperative brachytherapy had better 5-year disease-free survival compared to patients who underwent surgery alone, 93.6% and 74.4% respectively (p = 0.04). CONCLUSION Although preoperative brachytherapy was significantly associated with more severe postoperative complications, better pathologic features were obtained on surgical specimens and led to a better 5-year disease-free survival in IB2 cervical cancer.
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Affiliation(s)
- M Kissel
- Radiation Oncology Department, Institut Curie, Paris, France.
| | - V Balaya
- Gynecology Department, Foch Hospital, Suresnes, France; University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France
| | - B Guani
- Gynecology Department, Fribourg University Hospital, Fribourg, Switzerland; University of Fribourg, Fribourg, Switzerland
| | - L Magaud
- Hospices Civils de Lyon, Pôle IMER, Lyon F-69003, France
| | - P Mathevet
- Gynecology Department, Centre hospitalo-universitaire vaudois, Lausanne, Switzerland; University of Lausanne, Lausanne, Switzerland
| | - F Lécuru
- Breast, gynecology and reconstructive surgery unit, Institut Curie, Paris, France; Paris University, Paris, France
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Vieira-Serna S, Viveros-Carreño D, Rodríguez J, Grillo-Ardila CF, Angeles MA, Guerrero E, Sanabria D, Pareja R. Preoperative brachytherapy for early-stage cervical cancer: Systematic review and meta-analysis. Gynecol Oncol 2023; 169:4-11. [PMID: 36459858 DOI: 10.1016/j.ygyno.2022.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the rate of pathological response rate, and the oncological outcomes of preoperative brachytherapy (PBT) in early-stage cervical cancer. METHODS A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and meta-analyses (PRISMA) statement. MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus databases were searched from inception until April 2022. Only English and French articles were included. Studies containing data about pathology response or oncological outcomes among patients who received PBT as compared to those who underwent up-front surgery in early-stage cervical cancer were included. This study was registered in PROSPERO (CRD42022319036). RESULTS Thirteen studies met the inclusion criteria, 3 randomized controlled trials (RCT), and 10 non-randomized studies (NRS). The 5-year survival was significantly higher in the PBT group compared with the up-front surgery group (OR 1.78, 95% CI 1.11-2.84, I2 = 0%) in the NRS. Recurrence rate was significantly lower in the PBT group compared with in up-front surgery group in the analysis of the RCT but not in NRS, (OR 0.34, 95% CI 0.13-0.91, I2 not applicable) and (OR 0.72, 95% CI 0.26-1.95, I2 = 51%) respectively. PBT was associated with a statistically significant lower rate of positive margins (OR 0.28, 95% CI 0.09-0.89; I2 = 42%) in the RCT and with a significantly higher rate of complete pathology response (CPR) in the RCT analysis (OR 2.55, 95% CI 1.11-5.85, I2 = 0%) and in the NRS (OR 9.64, 95% CI 1.88-49.48, I2 = 76%) compared with the up-front surgery group. CONCLUSION Preoperative brachytherapy in patients with early-stage cervical cancer could improve pathologic and oncologic outcomes, but it should be assessed in high-quality randomized controlled trials before its implementation in clinical practice.
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Affiliation(s)
- Santiago Vieira-Serna
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá́, Colombia; Universidad Militar Nueva Granada, Bogotá, Colombia.
| | - David Viveros-Carreño
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá́, Colombia; Department of Gynecologic Oncology, Clínica Universitaria Colombia and Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo - CTIC: Bogotá, Colombia; Department of Gynecologic Oncology, Clínica Los Nogales, Bogotá, Colombia
| | - Juliana Rodríguez
- Department of Gynecology and Obstetrics, Section of Gynecologic Oncology, Fundación Santa Fe de Bogotá, Bogotá, Colombia; Cancer Clinical and Epidemiological Research Group, Instituto Nacional de Cancerología, Bogotá́, Colombia
| | - Carlos F Grillo-Ardila
- Cancer Clinical and Epidemiological Research Group, Instituto Nacional de Cancerología, Bogotá́, Colombia; Department Gynecology and Obstetrics, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Martina Aida Angeles
- Department of Surgical Oncology, Institut Claudius Regaud - Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France
| | - Eduardo Guerrero
- Department of Radiotherapy, Instituto Nacional de Cancerología, Bogotá́, Colombia
| | - Daniel Sanabria
- Department of Gynecology and Obstetrics, Section of Gynecologic Oncology, Fundación Santa Fe de Bogotá, Bogotá, Colombia; Department of Gynecology and Obstetrics, Section of Gynecologic Oncology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Rene Pareja
- Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotá́, Colombia; Department Gynecologic Oncology, Clínica ASTORGA, Medellín, Colombia
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Gauci PA, Kee DLC, Thamphya B, Schiappa R, Delotte J, Chand-Fouche ME, Hannoun-Levi JM. Preoperative high-dose-rate brachytherapy for high-risk early-stage cervical cancer: Long-term clinical outcome analysis. Brachytherapy 2022; 21:273-282. [PMID: 35094933 DOI: 10.1016/j.brachy.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/16/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To report long-term oncological and toxicity outcomes after high-dose-rate brachytherapy (HDB) followed by oncologic surgery for patients with early-stage cervical cancer. METHODS AND MATERIALS From 2005 to 2019, all patients treated with preoperative HDB at Antoine Lacassagne Cancer Center for early-stage (IB1-IB2-IIA - FIGO 2018) cervical cancer with local relapse risk factors were included. HDB was performed followed by hysterectomy. Oncological and toxicity outcomes were evaluated prospectively. RESULTS We identified 61 patients, with a median follow-up of 84 months. Posthysterectomy complete pathological response was observed in 46 patients (75.4%). Six patients (9.8%) experienced recurrence, including 4 local relapses (6.6%), and 2 deaths (3.3%) due to cervical cancer. Five-year local, nodal and metastatic relapse-free survivals were 94% (95% CI 87-100%), 96% (95% CI 90-100%) and 93% (95% CI 86-100%) respectively. Five-year overall survival was 98% (95% CI 95-100%). No grade ≥ 3 acute toxicity was observed, and 3 patients (4.9%) experienced grade 2 acute toxicity. One patient presented grade 4 late digestive toxicity, and 6 patients had grade 2 late toxicity. Only 1 patient still had grade 2 toxicity, after 9 years follow-up. CONCLUSIONS To our knowledge, we are reporting the longest follow-up of a preoperative HDB cohort. With similar oncological outcomes and less morbidity compared to primary surgery treatment followed more or less by adjuvant radiotherapy, HDB followed by hysterectomy could be a promising therapeutic option for early-stage cervical cancers with poor prognostic factors.
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Affiliation(s)
- Pierre-Alexis Gauci
- Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, Nice Cedex 2, Nice, France; Department of Obstetrics and Gynecology, Reproduction and Fetal Medicine, CHU de Nice, University of Côte d'Azur, Nice, France
| | - Daniel Lam Cham Kee
- Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, Nice Cedex 2, Nice, France
| | - Brice Thamphya
- Department of Statistics, Antoine Lacassagne Cancer Center - University of Côte d'Azur, Nice, France
| | - Renaud Schiappa
- Department of Statistics, Antoine Lacassagne Cancer Center - University of Côte d'Azur, Nice, France
| | - Jerome Delotte
- Department of Obstetrics and Gynecology, Reproduction and Fetal Medicine, CHU de Nice, University of Côte d'Azur, Nice, France
| | - Marie-Eve Chand-Fouche
- Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, Nice Cedex 2, Nice, France
| | - Jean-Michel Hannoun-Levi
- Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, Nice Cedex 2, Nice, France.
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Varela Cagetti L, Gonzague-Casabianca L, Zemmour C, Lambaudie E, Houvenaeghel G, Provansal M, Sabatier R, Sabiani L, Blache G, Jauffret C, Ferré M, Mailleux H, Paciencia M, Tallet A. The impact of modern preoperative high-dose-rate brachytherapy in early-stage cervical cancer. Gynecol Oncol 2021; 161:166-172. [PMID: 33563488 DOI: 10.1016/j.ygyno.2021.01.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/25/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To analyze the clinical outcomes and the safety of preoperative high-dose-rate (HDR) image-guided adaptive brachytherapy (IGABT) followed by minimally invasive surgery (MIS) in the multidisciplinary management of early-stage cervical cancer. METHODS AND MATERIALS Medical records of all consecutive patients with early-stage cervical cancer treated at our institution between 2012 and 2018 with preoperative IGABT in a multidisciplinary approach were reviewed. Treatment schedule was pelvic node dissection, preoperative IGABT followed 6-8 week later by MIS hysterectomy. RESULTS Seventy patients with cervical cancer FIGO stages (IB1 18.6%, IB2 75.7% and IIA1 5.7%) were treated by preoperative HDR brachytherapy. With a median follow-up of 37.4 months [95% confidence interval, 32.1-39.7 months] isolated vaginal vault recurrence was not observed, 3 pelvic relapses were reported (4.3%). None of patients received postoperative radiotherapy (EBRT) or radiochemotherapy. The estimated 3-year local and pelvis relapse free survival for the entire population were respectively 98% [95% confidence interval, 89%-100%] and 90% [80%-96%]. The estimated 3-year disease-free survival (DFS) for the entire population was 88% [77-94%]. The 3-year overall survival (OS) rate was 97% [88%-99%]. Microscopic vaginal resection margin (R1) was observed in one patient ([1].4%). Lymph-vascular space invasion (LVSI) was found found in 6 (8.6%) patients. Forty-eight late complications in 36 patients (51.4%) were observed. Five (7.1%) grade 3 vaginal wound dehiscence toxicities were observed. Urinary and gastrointestinal toxicities were grade 1-2. No grade 4-5 complications were observed. CONCLUSIONS Preoperative image-guided adaptive brachytherapy followed by minimally invasive surgery allows high local control, reduces positive surgical margins and rates of lymph-vascular space invasion avoiding adjuvants treatments. Surgical approaches must be discussed with patients including preoperative brachytherapy as a down-staging treatment.
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Affiliation(s)
| | | | - Christophe Zemmour
- Department of Clinical Research and Investigation, Biostatistics and Methodology Unit, Institut Paoli-Calmettes, Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Eric Lambaudie
- Department of Surgical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, CRCM, 13000 Marseille, France
| | - Gilles Houvenaeghel
- Department of Surgical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, CRCM, 13000 Marseille, France; Aix-Marseille University, Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Marseille, France; Department of Medical Physics, Institut Paoli-Calmettes, Marseille, France
| | - Magalie Provansal
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Renaud Sabatier
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France; Département of Molecular Oncology, Institut Paoli-Calmettes, INSERM UMR1068, CNRS UMR725, Marseille, France
| | - Laura Sabiani
- Departemet of Oncology Surgery 2, Institut Paoli-Calmettes, Marseille, France
| | - Guillaume Blache
- Departemet of Oncology Surgery 2, Institut Paoli-Calmettes, Marseille, France
| | - Camille Jauffret
- Departemet of Oncology Surgery 2, Institut Paoli-Calmettes, Marseille, France
| | - Marjorie Ferré
- Department of Medical Physics, Institut Paoli-Calmettes, Marseille, France
| | - Hugues Mailleux
- Department of Medical Physics, Institut Paoli-Calmettes, Marseille, France
| | - Maria Paciencia
- Department of Biopathology, Institut Paoli-Calmettes, Marseille, France
| | - Agnès Tallet
- Department of Radiation Oncology, Institut Paoli-Calmettes, Marseille, France
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Allanson ER, Powell A, Bulsara M, Lee HL, Denny L, Leung Y, Cohen P. Morbidity after surgical management of cervical cancer in low and middle income countries: A systematic review and meta-analysis. PLoS One 2019; 14:e0217775. [PMID: 31269024 PMCID: PMC6608935 DOI: 10.1371/journal.pone.0217775] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 05/19/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To investigate morbidity for patients after the primary surgical management of cervical cancer in low and middle-income countries (LMIC). METHODS The Pubmed, Cochrane, the Cochrane Central Register of Controlled Trials, Embase, LILACS and CINAHL were searched for published studies from 1st Jan 2000 to 30th June 2017 reporting outcomes of surgical management of cervical cancer in LMIC. Random-effects meta-analytical models were used to calculate pooled estimates of surgical complications including blood transfusions, ureteric, bladder, bowel, vascular and nerve injury, fistulae and thromboembolic events. Secondary outcomes included five-year progression free (PFS) and overall survival (OS). FINDINGS Data were available for 46 studies, including 10,847 patients from 11 middle income countries. Pooled estimates were: blood transfusion 29% (95%CI 0.19-0.41, P = 0.00, I2 = 97.81), nerve injury 1% (95%CI 0.00-0.03, I2 77.80, P = 0.00), bowel injury, 0.5% (95%CI 0.01-0.01, I2 = 0.00, P = 0.77), bladder injury 1% (95%CI 0.01-0.02, P = 0.10, I2 = 32.2), ureteric injury 1% (95%CI 0.01-0.01, I2 0.00, P = 0.64), vascular injury 2% (95% CI 0.01-0.03, I2 60.22, P = 0.00), fistula 2% (95%CI 0.01-0.03, I2 = 77.32, P = 0.00,), pulmonary embolism 0.4% (95%CI 0.00-0.01, I2 26.69, P = 0.25), and infection 8% (95%CI 0.04-0.12, I2 95.72, P = 0.00). 5-year PFS was 83% for laparotomy, 84% for laparoscopy and OS was 85% for laparotomy cases and 80% for laparoscopy. CONCLUSION This is the first systematic review and meta-analysis of surgical morbidity in cervical cancer in LMIC, which highlights the limitations of the current data and provides a benchmark for future health services research and policy implementation.
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Affiliation(s)
- Emma R. Allanson
- Division of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Western Australia, Crawley, WA, Australia
| | - Aime Powell
- Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Max Bulsara
- Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Hong Lim Lee
- Obstetrics and Gynaecology, Joondalup Health Campus, Joondalup, WA, Australia
| | - Lynette Denny
- Department Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council Gynaecological Cancer Research Centre, Cape Town, South Africa
| | - Yee Leung
- Division of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Western Australia, Crawley, WA, Australia
| | - Paul Cohen
- Division of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Western Australia, Crawley, WA, Australia
- Department of Gynaecological Oncology, Bendat Family Comprehensive Cancer Centre, St John of God, Subiaco, WA, Australia
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Chen C, Zhang W, Liu P, Su G, Gong S, Li W. Discrepancies between clinical staging and surgicopathologic findings in early-stage cervical cancer and prognostic significance. Int J Gynaecol Obstet 2019; 145:287-292. [PMID: 30903619 DOI: 10.1002/ijgo.12807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 11/07/2018] [Accepted: 03/20/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate discrepancies between clinical staging and surgicopathologic findings in early-stage cervical cancer and explore the prognostic significance of these discrepancies. METHODS A retrospective review of the clinical records of individuals with early-stage cervical cancer who underwent primary radical surgery in Nanfang Hospital of Southern Medical University, Guangzhou, China, between 2007 and 2013. Discrepancies in clinical staging were investigated by using surgicopathologic findings as the reference. Individuals were classified according to the type of discrepancy. Kaplan-Meier plots were generated to explore the prognostic significance of stage discrepancies. RESULTS Among 266 individuals included in the study, 182 (68.4%) were accurately staged, 58 (21.8%) were clinically over-staged, and 26 (9.8%) were clinically under-staged. More relapses (19.2% vs 4.9% vs 6.8%, P=0.027) and deaths (11.5% vs 2.2% vs 3.4%, P=0.048) were observed among those who were clinically under-staged than among those who were accurately or clinically over-staged. Clinical under-staging was associated with poorer disease-free survival (P=0.003) and poorer overall survival (P=0.020) over a median follow-up of 43.9 months. CONCLUSION Significant discrepancies were found between clinical staging and surgicopathologic findings in early-stage cervical cancer. Stage discrepancies were found to have prognostic significance, with clinical under-staging identified as a potential adverse prognostic factor.
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Affiliation(s)
- Chunlin Chen
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Weifeng Zhang
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Ping Liu
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Guidong Su
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Shipeng Gong
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Weili Li
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou, China
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Outcome of early stage cervical cancer patients treated according to a radiosurgical approach: Clinical results and prognostic factors. Gynecol Oncol 2017; 144:541-546. [DOI: 10.1016/j.ygyno.2016.12.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 12/28/2016] [Accepted: 12/31/2016] [Indexed: 11/21/2022]
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Escande A, Mazeron R, Gouy S, Bentivegna E, Maroun P, Fahra G, Oberlander AS, Dumas I, Castelnau-Marchand P, Deutsch E, Morice P, Haie-Meder C, Chargari C. Preoperative image-guided brachytherapy in early stage cervical cancers. Radiother Oncol 2016; 120:455-459. [DOI: 10.1016/j.radonc.2016.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 07/02/2016] [Accepted: 07/04/2016] [Indexed: 01/09/2023]
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Saltari M, Corrado G, Patrizi L, Vizza E. Comment: Survival rate comparisons amongst cervical cancer patients treated with an open, robotic-assisted or laparoscopic radical hysterectomy: A five year experience. Surg Oncol 2016; 25:244-5. [PMID: 27566029 DOI: 10.1016/j.suronc.2016.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/09/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Maria Saltari
- Department of Surgery, Section of Gynaecology and Obstetrics, Tor Vergata University of Rome, Rome, Italy
| | - Giacomo Corrado
- Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
| | - Lodovico Patrizi
- Department of Surgery, Section of Gynaecology and Obstetrics, Tor Vergata University of Rome, Rome, Italy
| | - Enrico Vizza
- Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy
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