caa a22 4500 445334630 CHVBK 20180317142750.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1245/s10434-011-1767-3 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1767-3 Class III Nerve-sparing Radical Hysterectomy Versus Standard Class III Radical Hysterectomy: An Observational Study [Elektronische Daten] [Antonino Ditto, Fabio Martinelli, Flavia Mattana, Claudio Reato, Eugenio Solima, Marialuisa Carcangiu, Edward Haeusler, Luigi Mariani, Francesco Raspagliesi] Background: The purpose of this observational study was to evaluate disease-free survival, overall survival, local recurrence rate, and morbidities in patients submitted to class III nerve-sparing radical hysterectomy (NSRH) compared with standard radical hysterectomy (RH) in cervical cancer (CC). This was a comparative study in the context of multimodal therapies. Materials and Methods: We investigated patients with CC admitted to the National Cancer Institute of Milan between January 4, 2001, and September 29, 2009, treated with NSRH. We compared patients operated with RH between March 20, 1980, and December 28, 1995. A total of 496 patients were enrolled. The median follow-up was 93months (42 and 159months for the NSRH and RH groups, respectively). Results: The overall number of relapses was 30 out of 185 and 60 out of 311 for NSRH and RH, respectively. Five-year disease-free survival estimate was 78.9% (95% confidence interval [CI] 72.0-85.7) in NSRH and 79.8% (95% CI 75.3-84.3) in RH (P=0.519). Five-year overall survival estimate was 90.8% (95% CI 85.9-95.6) in NSRH and 84.1% (95% CI 8.0-88.3) in RH (P=0.192). Rates of postoperative serious complications were 9.7% and 19.6% for NSRH and RH, respectively (P=0.004). Positive pelvic lymph node and vagina status were significant (P<0.01) independent predictors by multivariable analyses. Conclusions: The oncologic results were comparable between NSRH and conventional class III RH in the context of two multimodal treatments. Bladder function and postoperative complications rate are improved by nerve-sparing technique. The nerve-sparing technique should be considered in all CC patients addressed to surgery because it improves functional outcome and preserves radicality without compromising overall survival. Society of Surgical Oncology, 2011 Ditto Antonino Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy aut Martinelli Fabio Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy aut Mattana Flavia Unit of Clinical Epidemiology and Trial Organisation, IRCCS National Cancer Institute, Milan, Italy aut Reato Claudio Department of Obstetrics and Gynaecology, Treviglio/Caravaggio Hospital, Bergamo, Italy aut Solima Eugenio Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy aut Carcangiu Marialuisa Department of Pathology, IRCCS National Cancer Institute, Milan, Italy aut Haeusler Edward Department of Anesthesiology, IRCCS National Cancer Institute, Milan, Italy aut Mariani Luigi Unit of Clinical Epidemiology and Trial Organisation, IRCCS National Cancer Institute, Milan, Italy aut Raspagliesi Francesco Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy aut Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3469-3478 1068-9265 18:12<3469 2011 18 10434 https://doi.org/10.1245/s10434-011-1767-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1767-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ditto Antonino Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy aut NATIONALLICENCE 700 1- Martinelli Fabio Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy aut NATIONALLICENCE 700 1- Mattana Flavia Unit of Clinical Epidemiology and Trial Organisation, IRCCS National Cancer Institute, Milan, Italy aut NATIONALLICENCE 700 1- Reato Claudio Department of Obstetrics and Gynaecology, Treviglio/Caravaggio Hospital, Bergamo, Italy aut NATIONALLICENCE 700 1- Solima Eugenio Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy aut NATIONALLICENCE 700 1- Carcangiu Marialuisa Department of Pathology, IRCCS National Cancer Institute, Milan, Italy aut NATIONALLICENCE 700 1- Haeusler Edward Department of Anesthesiology, IRCCS National Cancer Institute, Milan, Italy aut NATIONALLICENCE 700 1- Mariani Luigi Unit of Clinical Epidemiology and Trial Organisation, IRCCS National Cancer Institute, Milan, Italy aut NATIONALLICENCE 700 1- Raspagliesi Francesco Department of Gynecologic Oncology, IRCCS National Cancer Institute, Milan, Italy aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3469-3478 1068-9265 18:12<3469 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer