Abstract:
OBJECTIVE:A prospective, randomized controlled trial was conducted to evaluate the efficacy of nerve-sparing radical hysterectomy (NSRH) in preserving bladder function and its oncologic safety in the treatment of cervical cancer. METHODS:From March 2003 to November 2005, 92 patients with cervical cancer stage IA2 to IIA were randomly assigned for surgical treatment with conventional radical hysterectomy (CRH) or NSRH, and 86 patients finally included in the analysis. Adequacy of nerve sparing, radicality, bladder function, and oncologic safety were assessed by quantifying the nerve fibers in the paracervix, measuring the extent of paracervix and harvested lymph nodes (LNs), urodynamic study (UDS) with International Prostate Symptom Score (IPSS), and 10-year disease-free survival (DFS), respectively. RESULTS:There were no differences in clinicopathologic characteristics between two groups. The median number of nerve fiber was 12 (range, 6 to 21) and 30 (range, 17 to 45) in the NSRH and CRH, respectively (p<0.001). The extent of resected paracervix and number of LNs were not different between the two groups. Volume of residual urine and bladder compliance were significantly deteriorated at 12 months after CRH. On the contrary, all parameters of UDS were recovered no later than 3 months after NSRH. Evaluation of the IPSS showed that the frequency of long-term urinary symptom was higher in CRH than in the NSRH group. The median duration before the postvoid residual urine volume became less than 50 mL was 11 days (range, 7 to 26 days) in NSRH group and was 18 days (range, 10 to 85 days) in CRH group (p<0.001). No significant difference was observed in the 10-year DFS between two groups. CONCLUSION:NSRH appears to be effective in preserving bladder function without sacrificing oncologic safety.
journal_name
J Gynecol Oncoljournal_title
Journal of gynecologic oncologyauthors
Roh JW,Lee DO,Suh DH,Lim MC,Seo SS,Chung J,Lee S,Park SYdoi
10.3802/jgo.2015.26.2.90subject
Has Abstractpub_date
2015-04-01 00:00:00pages
90-9issue
2eissn
2005-0380issn
2005-0399pii
201504090journal_volume
26pub_type
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更新日期:2014-07-01 00:00:00
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pub_type: 已发布勘误
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更新日期:2019-09-01 00:00:00
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更新日期:2019-07-01 00:00:00
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更新日期:2018-01-01 00:00:00