title: Class III NSRH: oncological outcome in 170 cervical cancer patients.
abstract: OBJECTIVE
  To analyze local recurrence rate (LRR), morbidities and oncologic outcome of class III nerve-sparing radical hysterectomy.
  
  
  METHODS
  170 consecutive class III NSRH cases were performed. Nineteen patients were addressed directly to surgery whilst neoadjuvant chemotherapy was administered in 151 patients. The majority of patients had SCC (75%). The median follow-up was 31 months.
  
  
  RESULTS
  The mean age was 50 [27-78] years. Mean post-operative hospital stay was 7 [3-16] days. 2 intraoperative complications occurred. Operating time and blood loss was similar to the state-of-the-art of conventional radical hysterectomy. Overall G3-4 complication rate was 8.2 % (14/170). Early G3-4 complication rate was 3.5% (6/170). Late G3-4 complication rate was: 4.7%. (8/170). Positive pelvic nodes were noted in 31 patients (18.2%). Vagina and parametrial involvement were present in 38 (22%) and 27 (15.8%) patients, respectively. LRR was 10% (17/170). The sites of relapse were: 12 pelvic, 5 vaginal. There were 9 patients DOD. The 2-year and 5-year DFS rates were 89% and 81%, respectively. Univariate and multivariate analysis identified vagina involvement and postoperative treatment as significant prognostic factors.
  
  
  CONCLUSIONS
  The oncologic results of NSRH were similar to the state-of-the-art of conventional radical hysterectomy. Two years DFS in relation to FIGO stage of disease was 92.3, 89.2 and 86.1 % respectively for IB1, IB2, IIB comparable to literature data. The early and late complications rate related to autonomic injury was significantly lower. The nerve-sparing technique should be considered in all cervical cancer patients addressed to surgery.
authors: Department of Gynecologic Oncology, IRCCS Istituto Nazionale Tumori, Milan, Italy. antonino.ditto@istitutotumori.mi.it
authors: Antonino
authors: A
authors: Ditto
authors: Fabio
authors: F
authors: Martinelli
authors: Francesco
authors: F
authors: Hanozet
authors: Claudio
authors: C
authors: Reato
authors: Eugenio
authors: E
authors: Solima
authors: Flavia
authors: F
authors: Zanaboni
authors: Barbara
authors: B
authors: Grijuela
authors: Marialuisa
authors: M
authors: Carcangiu
authors: Edward
authors: E
authors: Haeusler
authors: Francesco
authors: F
authors: Raspagliesi
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009017:Morbidity; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*