North Texas GME Research Forum 2024

Files

Download

Download Poster or Presentation (483 KB)

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

Comments

3rd Place - Research Category

Overall Research Forum Winner (Most Votes)

Surgical Margin Analysis in Early-Stage Cervical Cancer: An HCA Retrospective Study

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.