MONDAY, June 1 (HealthDay News) -- A new surgical technique that removes the Fallopian tubes, uterus, and parts of the vagina is effective in preventing recurrences in women with cervical cancer compared with radical hysterectomy, according to a study published online June 1 in The Lancet Oncology.
Michael Hockel, M.D., and colleagues from the University of Leipzig in Germany performed a total mesometrial resection without adjuvant radiation in 212 women with stage IB, IIA, and selected IIB cervical cancer, which consisted of removing the embryologically defined uterovaginal (Müllerian) compartment except its distal part.
After a median follow-up of 41 months, the researchers observed pelvic recurrences in three patients, pelvic and distant recurrences in two patients, and distant recurrences in five patients. The probability of recurrence-free survival was 94 percent and that of five-year overall survival was 96 percent. Grade 2 morbidity was observed in 9 percent of patients, most commonly vascular complications. The surgery resulted in local tumor control regardless of the metric extension of the resection margins. The authors further note that pelvic relapse landscapes from 34 women who had undergone conventional hysterectomy indicated that recurrences were more likely in the incompletely removed remnants of the Müllerian compartment, the ligamentous mesometrium adjacent to the mesorectum.
"Resection of the embryologically defined uterovaginal compartment seems to be pivotal for pelvic control in patients with cervical cancer," Hockel and colleagues conclude. "Total mesometrial resection without adjuvant radiation has great potential to improve the effectiveness of surgical treatment of early-stage cervical cancer."
Abstract
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