Title

The MEMORY Study: MulticentEr study of Minimally invasive surgery versus Open Radical hYsterectomy in the management of early-stage cervical cancer: Survival outcomes.

Authors

Mario M Leitao, Memorial Sloan Kettering Cancer Center
Qin C Zhou, Memorial Sloan Kettering Cancer Center
Benny Brandt, Memorial Sloan Kettering Cancer Center
Alexia Iasonos, Memorial Sloan Kettering Cancer Center
Vasileios Sioulas, Memorial Sloan Kettering Cancer Center
Katherine Lavigne Mager, Memorial Sloan Kettering Cancer Center
Mark Shahin, Abington Jefferson Hospital
Shaina Bruce, Abington Jefferson Hospital
Destin R Black, Willis-Knighton Physician Network
Carrie G Kay, Willis-Knighton Physician Network
Meeli Gandhi, Willis-Knighton Physician Network
Maira Qayyum, Willis-Knighton Physician Network
Jennifer Scalici, University of South Alabama Mitchell Cancer Institute
Nathaniel L Jones, University of South Alabama Mitchell Cancer Institute
Rajesh Paladugu, University of South Alabama Mitchell Cancer Institute
Jubilee Brown, Levine Cancer Institute
R Wendel Naumann, Levine Cancer Institute
Monica D Levine, Levine Cancer Institute
Alberto Mendivil, Hoag Cancer Center
Peter C Lim, University of Nevada School of Medicine
Elizabeth Kang, University of Nevada School of Medicine
Leigh A Cantrell, University of Virginia
Mackenzie W Sullivan, University of Virginia
Martin A. Martino MD, Lehigh Valley Health NetworkFollow
Melissa Kratz RN, MSN, AOCN, Lehigh Valley Health NetworkFollow
Valentin Kolev, Icahn School of Medicine
Shannon Tomita, Icahn School of Medicine
Charles A Leath, University of Alabama
Teresa K L Boitano, University of Alabama
David W Doo, University of Alabama
Colleen Feltmate, Brigham and Women's Hospital
Ronan Sugrue, Brigham and Women's Hospital
Alexander B Olawaiye, University of Pittsburgh School of Medicine
Ester Goldfeld, University of Pittsburgh School of Medicine
Sarah E Ferguson, Princess Margaret Cancer Centre/University Health Network
Jessa Suhner, Mount Sinai West/Mount Sinai Morningside
Nadeem R Abu-Rustum, Memorial Sloan Kettering Cancer Center

Publication/Presentation Date

7-22-2022

Abstract

OBJECTIVE: The Laparoscopic Approach to Cervical Cancer (LACC) trial found that minimally invasive radical hysterectomy compared to open radical hysterectomy compromised oncologic outcomes and was associated with worse progression-free survival (PFS) and overall survival (OS) in early-stage cervical carcinoma. We sought to assess oncologic outcomes at multiple centers between minimally invasive (MIS) radical hysterectomy and OPEN radical hysterectomy.

METHODS: This is a multi-institutional, retrospective cohort study of patients with 2009 FIGO stage IA1 (with lymphovascular space invasion) to IB1 cervical carcinoma from 1/2007-12/2016. Patients who underwent preoperative therapy were excluded. Squamous cell carcinoma, adenocarcinoma, and adenosquamous carcinomas were included. Appropriate statistical tests were used.

RESULTS: We identified 1093 cases for analysis-715 MIS (558 robotic [78%]) and 378. OPEN procedures. The OPEN cohort had more patients with tumors >2 cm, residual disease in the hysterectomy specimen, and more likely to have had adjuvant therapy. Median follow-up for the MIS and OPEN cohorts were 38.5 months (range, 0.03-149.51) and 54.98 months (range, 0.03-145.20), respectively. Three-year PFS rates were 87.9% (95% CI: 84.9-90.4%) and 89% (95% CI: 84.9-92%), respectively (P = 0.6). On multivariate analysis, the adjusted HR for recurrence/death was 0.70 (95% CI: 0.47-1.03; P = 0.07). Three-year OS rates were 95.8% (95% CI: 93.6-97.2%) and 96.6% (95% CI: 93.8-98.2%), respectively (P = 0.8). On multivariate analysis, the adjusted HR for death was 0.81 (95% CI: 0.43-1.52; P = 0.5).

CONCLUSION: This multi-institutional analysis showed that an MIS compared to OPEN radical hysterectomy for cervical cancer did not appear to compromise oncologic outcomes, with similar PFS and OS.

ISSN

1095-6859

Disciplines

Medicine and Health Sciences

PubMedID

35879128

Department(s)

Department of Obstetrics and Gynecology, Hematology-Medical Oncology Division, Patient Care Services / Nursing

Document Type

Article

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