North Texas Research Forum 2024
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Division
North Texas
Hospital
Medical City Arlington
Specialty
Obstetrics & Gynecology
Document Type
Presentation
Publication Date
2024
Keywords
cervical cancer, retrospective study
Disciplines
Medicine and Health Sciences | Neoplasms | Obstetrics and Gynecology
Abstract
Objective: This study aimed to compare surgical margin analysis on final pathology in robotic assisted approach hysterectomy vs. all other approaches in early-stage cervical cancer. Methods: Patients with clinical early-stage disease who underwent total and radical hysterectomy from the years 2018-2023 were categorized into robotic assisted approach group (RAH) vs all other approaches including laparoscopic hysterectomy (LAH), laparoscopic assisted vaginal hysterectomy (LAVH), and open hysterectomy (TAH). Fisher’s exact test was used for analysis of the primary outcome measure. Results: A total of 92 patients met inclusion criteria. Mode of surgery included: 83 RAH (90.2%), 6 LAH (6.5%), 2 TAH (2.17%), and 1 LAVH (1.08%). Histologic subtypes included: 64 with squamous (69.56%), 27 with adenocarcinoma (29.34%), and 1 with adenosquamous (1.08%). A positive surgical margin status was found to have a significant association with the presence of LVSI (p=0.0002, RR= 30.0). The use of robotic assisted approach in total and radical hysterectomy for early-stage cervical cancer was not found to have a statistically significant association with surgical margin status (p=0.4707) when adjusted for uterine weight and length. No significant difference was observed in surgical margin status when adjusted for pathological stage (=0.0565, p=0.9721). Of the patients sampled, 58 were stage IA (63.04%), 31 were stage IB (33.69%), and 3 were stage II or III (3.26%) on final pathology. Positive margin status was observed in 6.02% of the robotic assisted group and 11.11% in the all other approaches group. Lymphovascular space invasion (LVSI) was observed at a lower rate (13.25 vs 22.2%) in the robotic assisted hysterectomy group. Radical hysterectomy was found to be attempted/completed at a higher rate in RAH vs all other approaches cohort (38.05% vs 22.22%). Conclusion: The study demonstrated that surgical route and margins played a role only in LVSI patients.
Original Publisher
HCA Healthcare Graduate Medical Education
Recommended Citation
Stallworth, Chrystal; Moron, Abel; Tenzel, Nicole; Kremer, Timothy; and McCarroll, Michele, "Surgical Margin Analysis in Early-Stage Cervical Cancer: An HCA Retrospective Study" (2024). North Texas Research Forum 2024. 2.
https://scholarlycommons.hcahealthcare.com/northtexas2024/2