A Retrospective Analysis of Surgery for Cervical Stump Carcinoma at Early Stage (IA2-IIA2)

Lu Z, Wang T, Yuanyuan Gu Y, Ying Zhang Y, Junjun Qiu J* and Hua K*

Department of Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, China

^*Correspondance to: Junjun Qiu J 

 PDF  Full Text DOI: 10.25107/2474-1647.2687

Abstract

Purpose: Although supracervical hysterectomy is becoming a rare procedure, there are still many women with retained cervical stump. The purpose of this study was to assess the clinical outcomes of patients with cervical stump carcinoma treated with surgery. Material and Methods: A retrospective review was performed of all patients with cervical stump carcinoma treated with surgery in the Obstetrics & Gynecology Hospital of Fudan University from January 2000 to June 2018. Clinical characteristics, complications, pathological features, and followup data were retrieved from our database. Results: A total of 72 patients were included. The mean interval between supracervical hysterectomy and the diagnosis of carcinoma of the cervical stump was 10.5 years (range: 1 year to 35 years). In 84.7% of cases, symptoms drove the patient to seek medical attention and abnormal vaginal bleeding or discharge was the main reason. Histologic subtypes included squamous carcinomas (88.9%), adenocarcinomas (5.6%), adenosquamous carcinomas (4.2%), and neuroendocrine carcinomas (1.3%). The FIGO stage distribution was as follows: IA2 (2.8%); IB1 (68.1%); IB2 (8.3%); IIA1 (13.9%); IIA2 (6.9%). The patients received a radical trachelectomy and pelvic lymphadenectomy (58 via laparoscopy and 14 via laparotomy). Four cases received neoadjuvant chemotherapy. There were 5 parametrial infiltration (6.9%), 4 resection margin in filtration (5.6%), 18 lymph node metastasis (25%), 31 Lymph Vascular Space Invasion (LVSI) (43.1%), and 38 deep stromal invasion (52.8%) in all patients. Thirty eight cases (52.8%) received concurrent chemoradiotherapy after surgeries. Compared with laparotomy group, there was significantly less blood loss (P<0.001), shorter operative time (P=0.01), lower complication rate (P=0.002) and higher hospitalization fee (P<0.001) in laparoscopy group. There was no significant difference in the duration of hospital stay (P=0.312) between two groups. The median follow-up time was 50.5 months (range: 9 to 171 months). Eight patients were lost and 7 patients died. The median survival time was not shown both in laparoscopy and laparotomy group due to the minimum survival rates (0.862 and 0.917) were greater than 0.05. Conclusion: Surgery for cervical stump cancer at an early-stage is a viable and safe procedure. A longer follow-up period was needed to compare the impact of laparoscopy surgery and traditional laparotomy on survival.

Keywords

Cervical stump cancer; Complications; Laparoscopy

Cite the article

Lu Z, Wang T, Yuanyuan Gu Y, Ying Zhang Y, Junjun Qiu J, Hua K. A Retrospective Analysis of Surgery for Cervical Stump Carcinoma at Early Stage (IA2-IIA2). Clin Surg. 2019; 4: 2687..