Total mesometrial resection (TMMR) for cervical cancer FIGO IB–IIA: first results from the multicentric TMMR register study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Paul Buderath - , University of Duisburg-Essen (Author)
  • Maciej Stukan - , Pomeranian Hospitals (Author)
  • Wencke Ruhwedel - , Klinikum Gütersloh (Author)
  • Deivis Strutas - , University of Zurich (Author)
  • Gabriele Feisel-Schwickardi - , Klinikum Kassel GmbH (Author)
  • Pauline Wimberger - , Department of Gynecology and Obstetrics (Author)
  • Rainer Kimmig - , University of Duisburg-Essen (Author)

Abstract

Objective: The surgical concept of total mesometrial resection (TMMR) and therapeutic lymphadenectomy (tLNE) for the treatment of early cervical cancer is based on the ontogenetic cancer field model. Unicentric data show excellent locoregional control rates without adjuvant chemoradiation. However, there are so far no prospective, multicentric data supporting the method. Methods: The multicentric TMMR register study was designed to answer the question whether the concept of TMMR+tLNE could be transferred to different centers and surgeons without compromising the outstanding oncologic results described in a unicentric setting. Results: In 116 patients with cervical cancer stages IB–IIA, (International Federation of Gynecology and Obstetrics [FIGO] 2018), who underwent TMMR/tLNE, 25.0% were lymph node-positive. pT stages were pT1a in 3 patients (2.6%), pT1b1 in 82 (70.7%), pT1b2 in 18 (15.5%), pT2a in 4 (3.5%) and pT2b in 9 (7.8%). The overall recurrence rate was 7.8% in a median follow-up time of 24 months (6–80). Locoregional recurrences occurred in 6.0% of patients. One patient (0.9%) died from the disease during the observation period. Conclusion: These are the first multicentric data on the surgical concept of TMMR and tLNE for the treatment of cervical cancer FIGO IB–IIA. We were able to reproduce the excellent oncologic data described for the method albeit with a relatively short median observation time. A randomized controlled trial seems warranted to definitely establish TMMR+tLNE as the method of choice for the treatment of early cervical cancer. Trial Registration: ClinicalTrials.gov Identifier: NCT01819077.

Details

Original languageEnglish
Article numbere9
Journal Journal of gynecologic oncology : official journal of KSGOC
Volume33
Issue number1
Publication statusPublished - Jan 2022
Peer-reviewedYes

External IDs

PubMed 34910390

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • Cervical Cancer, Lymphadenectomy, Operative Surgical Procedures, Recurrence