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Results of a German wide survey towards current surgical approach in early stage cervical cancer NOGGO MONITOR 11.

ABSTRACT: Minimally invasive surgery (MIS) has become the standard approach in early stage cervical cancer (ECC). However, the recently published "LACC" trial and even others could show inferior PFS and OS of MIS compared to open radical hysterectomy. The results led to a widespread debate about the best surgical approach in ECC. The present survey aimed to get first insights after publication. NOGGO and AGE conducted a nationwide digital survey among 186 Gynecological Cancer Centers. Descriptive statistics and t-tests were performed using SPSS. A majority of the centers were of high expertise and/or experience in treatment of ECC and were highly aware of the LACC trial results. Trial quality and scientific value were rated as very good/good. However, still 40% would not change the standard of care to open surgery. Centers with higher volume and participating in clinical trials were more likely to change. This survey represents insights after the surprising results of recently published trials towards the surgical approach of ECC. There still seems to be a high need of future trials and possible explanations for the unexpected worse outcomes in the MIS group.

SUBMITTER: Armbrust R

PROVIDER: S-EPMC8105313 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Results of a German wide survey towards current surgical approach in early stage cervical cancer NOGGO MONITOR 11.

Armbrust Robert R Chen Frank F Richter Rolf R Muallem Mustafa Zela MZ Muallem Mustafa Zela MZ Mustea Alexander A Holthaus Bernd B Sehouli Jalid J

Scientific reports 20210507 1

Minimally invasive surgery (MIS) has become the standard approach in early stage cervical cancer (ECC). However, the recently published "LACC" trial and even others could show inferior PFS and OS of MIS compared to open radical hysterectomy. The results led to a widespread debate about the best surgical approach in ECC. The present survey aimed to get first insights after publication. NOGGO and AGE conducted a nationwide digital survey among 186 Gynecological Cancer Centers. Descriptive statisti ...[more]

PMID: 33963213

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Project description:BackgroundCervical cancer is the second most common cancer among women up to 65 years of age and is the most frequent cause of death from gynaecological cancers worldwide. Women with International Federation of Gynecology and Obstetrics (FIGO) stage IA2 cervical cancer have measured stromal invasion (when the cancer breaks through the basement membrane of the epithelium) of greater than 3 mm and no greater than 5 mm in depth with a horizontal surface extension of no more than 7 mm. For stage IA2 disease, radical hysterectomy with pelvic lymphadenectomy or radiotherapy is the standard treatment. In order to avoid complications of more radical surgical methods, less invasive options, such as simple hysterectomy, simple trachelectomy or conisation, with or without pelvic lymphadenectomy, may be feasible for stage IA2 disease, considering the relative low risk of local or distant metastatic disease. The evidence for less radical tumour excision and for the role of systematic lymphadenectomy in stage IA2 cervical cancer is not clear.ObjectivesTo evaluate the effectiveness and safety of less radical surgery in stage IA2 cervical cancer.Search methodsWe searched the Cochrane Gynaecological Cancer Group trials register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE up to September 2013. We also searched registers of clinical trials and abstracts of scientific meetings.Selection criteriaWe searched for randomised controlled trials (RCTs) that compared surgical techniques in women with stage IA2 cervical cancer.Data collection and analysisTwo review authors independently assessed whether potentially relevant studies met the inclusion criteria. We found no trials and, therefore, no data were analysed.Main resultsThe search strategy identified 982 unique references, which were all excluded on the basis of title and abstract because it was clear that they did not meet the inclusion criteria. We identified one relevant large ongoing trial, so it is anticipated that we will be able to add this evidence to this review in the future.Authors' conclusionsWe found no evidence to inform decisions about different surgical techniques in women with stage IA2 cervical cancer. In the future, the results of one large ongoing RCT should allow comparison of different types of surgery.

Dataset Information

Results of a German wide survey towards current surgical approach in early stage cervical cancer NOGGO MONITOR 11.

Publications

Results of a German wide survey towards current surgical approach in early stage cervical cancer NOGGO MONITOR 11.

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