Outcomes of Trachelectomy vs. Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis

Objective: To provide updated evidence on comparative efficacy for clinical outcomes of radical trachelectomy and radical hysterectomy in patients with early-stage cervical cancer.Methods: A systematic search was conducted in the PubMed, Scopus, Cochrane Database of Systematic Reviews, and Google sc...

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Autores principales:	Juan Guo, Qingwei Hu, Zaixing Deng, Xiaotian Jin
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	radical hysterectomy radical trachelectomy abdominal trachelectomy vaginal trachelectomy early stage cervical cancer meta-analysis Surgery RD1-811
Acceso en línea:	https://doaj.org/article/ae0cfc3cba854203a45c828198d574bf
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spelling	oai:doaj.org-article:ae0cfc3cba854203a45c828198d574bf2021-11-11T05:17:09ZOutcomes of Trachelectomy vs. Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis2296-875X10.3389/fsurg.2021.735944https://doaj.org/article/ae0cfc3cba854203a45c828198d574bf2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.735944/fullhttps://doaj.org/toc/2296-875XObjective: To provide updated evidence on comparative efficacy for clinical outcomes of radical trachelectomy and radical hysterectomy in patients with early-stage cervical cancer.Methods: A systematic search was conducted in the PubMed, Scopus, Cochrane Database of Systematic Reviews, and Google scholar databases. Studies were done in patients with early-stage cervical cancer that compared the outcomes between radical trachelectomy (RT) and hysterectomy (RH) were considered for inclusion in the review. The outcomes of interest were operative time, the volume of blood loss, need for blood transfusion, any complications, length of hospital stay, risk of recurrence, and survival. The strength of association was presented in the form of pooled relative risk (RR), hazards risk (HR), and weighted mean difference (WMD). Statistical analysis was done using STATA version 16.0.Results: A total of 12 articles were included in the meta-analysis. The majority were retrospective cohort-based studies. Compared to RH, the operative time (in min) was comparatively higher in RT (WMD 23.43, 95% CI: 5.63, 41.24). Patients undergoing RT had blood loss (in ml) similar to those undergoing RT (WMD −81.34, 95% CI: −170.36, 7.68). There were no significant differences in the risk of intra-operative (RR 1.61, 95% CI: 0.49, 5.28) and post-operative complications (RR 1.13, 95% CI: 0.54, 2.40) between the two groups. Patients in the RT group had lesser duration of post-operative hospital stay (in days) (WMD −1.65, 95% CI: −3.22, −0.09). There was no statistically significant difference in the risk of recurrence (HR 1.21, 95% CI: 0.68, 2.18), 5-year overall survival (HR 1.00, 95% CI: 0.99, 1.02), and recurrence-free survival (HR 0.99, 95% CI: 0.96, 1.01) between the two groups.Conclusion: Among the patients with early-stage cervical cancer, RT is similar to RH in safety and clinical outcomes. Future studies with a randomized design and larger sample sizes are needed to further substantiate these findings.Juan GuoQingwei HuZaixing DengXiaotian JinFrontiers Media S.A.articleradical hysterectomyradical trachelectomyabdominal trachelectomyvaginal trachelectomyearly stage cervical cancermeta-analysisSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	radical hysterectomy radical trachelectomy abdominal trachelectomy vaginal trachelectomy early stage cervical cancer meta-analysis Surgery RD1-811
spellingShingle	radical hysterectomy radical trachelectomy abdominal trachelectomy vaginal trachelectomy early stage cervical cancer meta-analysis Surgery RD1-811 Juan Guo Qingwei Hu Zaixing Deng Xiaotian Jin Outcomes of Trachelectomy vs. Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis
description	Objective: To provide updated evidence on comparative efficacy for clinical outcomes of radical trachelectomy and radical hysterectomy in patients with early-stage cervical cancer.Methods: A systematic search was conducted in the PubMed, Scopus, Cochrane Database of Systematic Reviews, and Google scholar databases. Studies were done in patients with early-stage cervical cancer that compared the outcomes between radical trachelectomy (RT) and hysterectomy (RH) were considered for inclusion in the review. The outcomes of interest were operative time, the volume of blood loss, need for blood transfusion, any complications, length of hospital stay, risk of recurrence, and survival. The strength of association was presented in the form of pooled relative risk (RR), hazards risk (HR), and weighted mean difference (WMD). Statistical analysis was done using STATA version 16.0.Results: A total of 12 articles were included in the meta-analysis. The majority were retrospective cohort-based studies. Compared to RH, the operative time (in min) was comparatively higher in RT (WMD 23.43, 95% CI: 5.63, 41.24). Patients undergoing RT had blood loss (in ml) similar to those undergoing RT (WMD −81.34, 95% CI: −170.36, 7.68). There were no significant differences in the risk of intra-operative (RR 1.61, 95% CI: 0.49, 5.28) and post-operative complications (RR 1.13, 95% CI: 0.54, 2.40) between the two groups. Patients in the RT group had lesser duration of post-operative hospital stay (in days) (WMD −1.65, 95% CI: −3.22, −0.09). There was no statistically significant difference in the risk of recurrence (HR 1.21, 95% CI: 0.68, 2.18), 5-year overall survival (HR 1.00, 95% CI: 0.99, 1.02), and recurrence-free survival (HR 0.99, 95% CI: 0.96, 1.01) between the two groups.Conclusion: Among the patients with early-stage cervical cancer, RT is similar to RH in safety and clinical outcomes. Future studies with a randomized design and larger sample sizes are needed to further substantiate these findings.
format	article
author	Juan Guo Qingwei Hu Zaixing Deng Xiaotian Jin
author_facet	Juan Guo Qingwei Hu Zaixing Deng Xiaotian Jin
author_sort	Juan Guo
title	Outcomes of Trachelectomy vs. Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis
title_short	Outcomes of Trachelectomy vs. Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis
title_full	Outcomes of Trachelectomy vs. Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis
title_fullStr	Outcomes of Trachelectomy vs. Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis
title_full_unstemmed	Outcomes of Trachelectomy vs. Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis
title_sort	outcomes of trachelectomy vs. hysterectomy for early-stage cervical cancer: a systematic review and meta-analysis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/ae0cfc3cba854203a45c828198d574bf
work_keys_str_mv	AT juanguo outcomesoftrachelectomyvshysterectomyforearlystagecervicalcancerasystematicreviewandmetaanalysis AT qingweihu outcomesoftrachelectomyvshysterectomyforearlystagecervicalcancerasystematicreviewandmetaanalysis AT zaixingdeng outcomesoftrachelectomyvshysterectomyforearlystagecervicalcancerasystematicreviewandmetaanalysis AT xiaotianjin outcomesoftrachelectomyvshysterectomyforearlystagecervicalcancerasystematicreviewandmetaanalysis
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Outcomes of Trachelectomy vs. Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis

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