TY - JOUR
T1 - Peritoneal carcinomatosis after minimally invasive surgery versus open radical hysterectomy
T2 - systematic review and meta-analysis
AU - Hoegl, Jorge
AU - Viveros-Carreño, David
AU - Palacios, Tatiana
AU - Gallego - Ardila, Andres
AU - Rauh-Hain, Jose Alejandro
AU - Estrada, Erick Estuardo
AU - Noll, Florencia
AU - Krause, Kate
AU - Baiocchi, Glauco
AU - Minig, Lucas
AU - Grillo - Ardila, Carlos Fernando
AU - Pareja, Rene
N1 - Publisher Copyright:
© IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/11/8
Y1 - 2022/11/8
N2 - Objective To assess the incidence of peritoneal carcinomatosis in patients undergoing minimally invasive or open radical hysterectomy for cervical cancer. Methods The MEDLINE (accessed through Ovid), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Clinical Trials, and Scopus databases were searched for articles published from inception up to April 2022. Articles published in English were considered. The included studies reported on patients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IA-IIA squamous cell carcinoma, adenocarcinoma, and/or adenosquamous carcinoma of the cervix who underwent primary surgery. Studies had to report at least one case of peritoneal carcinomatosis as a recurrence pattern, and only studies comparing recurrence after minimally invasive surgery versus open surgery were considered. Variables of interest were manually extracted into a standardized electronic database. This study was registered in PROSPERO (CRD42022325068). Results The initial search identified 518 articles. After the removal of the duplicate entries from the initial search, two authors independently reviewed the titles and abstracts of the remaining 453 articles. Finally, 78 articles were selected for full-text evaluation; 22 articles (a total of 7626 patients) were included in the analysis - one randomized controlled trial and 21 observational retrospective studies. The most common histology was squamous cell carcinoma in 60.9%, and the tumor size was <4 cm in 92.8% of patients. Peritoneal carcinomatosis pattern represented 22.2% of recurrences in the minimally invasive surgery approach versus 8.8% in open surgery, accounting for 15.5% of all recurrences. The meta-analysis of observational studies revealed a statistically significant higher risk of peritoneal carcinomatosis after minimally invasive surgery (OR 1.90, 95% CI 1.32 to 2.74, p<0.05). Conclusion Minimally invasive surgery is associated with a statistically significant higher risk of peritoneal carcinomatosis after radical hysterectomy for cervical cancer compared with open surgery.
AB - Objective To assess the incidence of peritoneal carcinomatosis in patients undergoing minimally invasive or open radical hysterectomy for cervical cancer. Methods The MEDLINE (accessed through Ovid), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Clinical Trials, and Scopus databases were searched for articles published from inception up to April 2022. Articles published in English were considered. The included studies reported on patients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IA-IIA squamous cell carcinoma, adenocarcinoma, and/or adenosquamous carcinoma of the cervix who underwent primary surgery. Studies had to report at least one case of peritoneal carcinomatosis as a recurrence pattern, and only studies comparing recurrence after minimally invasive surgery versus open surgery were considered. Variables of interest were manually extracted into a standardized electronic database. This study was registered in PROSPERO (CRD42022325068). Results The initial search identified 518 articles. After the removal of the duplicate entries from the initial search, two authors independently reviewed the titles and abstracts of the remaining 453 articles. Finally, 78 articles were selected for full-text evaluation; 22 articles (a total of 7626 patients) were included in the analysis - one randomized controlled trial and 21 observational retrospective studies. The most common histology was squamous cell carcinoma in 60.9%, and the tumor size was <4 cm in 92.8% of patients. Peritoneal carcinomatosis pattern represented 22.2% of recurrences in the minimally invasive surgery approach versus 8.8% in open surgery, accounting for 15.5% of all recurrences. The meta-analysis of observational studies revealed a statistically significant higher risk of peritoneal carcinomatosis after minimally invasive surgery (OR 1.90, 95% CI 1.32 to 2.74, p<0.05). Conclusion Minimally invasive surgery is associated with a statistically significant higher risk of peritoneal carcinomatosis after radical hysterectomy for cervical cancer compared with open surgery.
KW - adenocarcinoma
KW - cervical cancer
KW - laparoscopes
KW - laparotomy
KW - peritoneum
UR - http://www.scopus.com/inward/record.url?scp=85143497864&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85143497864&partnerID=8YFLogxK
U2 - 10.1136/ijgc-2022-003937
DO - 10.1136/ijgc-2022-003937
M3 - Article
C2 - 36351746
AN - SCOPUS:85143497864
SN - 1048-891X
VL - 32
SP - 1497
EP - 1504
JO - International Journal of Gynecological Cancer
JF - International Journal of Gynecological Cancer
IS - 12
ER -