-Original-

Effectiveness and Long-term Outcomes of Nerve-Sparing Radical Hysterectomy for Cervical Cancer

Akihito Yamamoto, Seiryu Kamoi, Mariko Ikeda, Takashi Yamada, Koichi Yoneyama and Toshiyuki Takeshita

Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan

Background: Radical hysterectomy (RH) is a type of radical surgery for cervical cancer. Urinary dysfunction due to RH worsens postoperative quality of life of patients with cervical cancer. Nerve-sparing RH (NSRH) technique has been used as an effective means to conserve urinary function. However, few reports have examine long-term outcomes after NSRH. This study describes the details and long-term outcomes of our nerve-sparing technique.
Methods: Sixty-one patients underwent radical hysterectomy in a 5-year period during which nerve-sparing technique was introduced; of these, 31 patients underwent NSRH and 30 underwent conventional RH. We retrospectively examined their medical records and compared postoperative urinary function and treatment outcomes between these two groups.
Results: The median time required for urinary residual volume to fall to ≤50 mL after removal of the urinary catheter was 6 days (range, 2-20 days) in the NSRH group and 13.5 days (range, 3-46 days) in the RH group. The results were significantly better in the NSRH group (p < 0.05). The mean follow-up period was 2456.3 days (range, 48-4,213 days). Analysis of curability revealed no significant difference between the two groups in local recurrence or long-term survival rates. The 5-year survival rate was 0.861 in the NSRH group and 0.782 in the RH group; the 10-year survival rate was 0.861 in the NSRH group and 0.679 in the RH group.
Conclusions: NSRH significantly improved postoperative urinary function without worsening local recurrence rates or long-term outcomes.

J Nippon Med Sch 2021; 88: 386-397

Keywords
uterine cervical neoplasms, radical hysterectomy, urination disorders, prognosis, organ-sparing treatments

Correspondence to
Akihito Yamamoto, Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
s7095@nms.ac.jp

Received, April 29, 2020
Accepted, July 2, 2020