More deaths seen for less invasive cervical cancer surgery

When a woman is diagnosed with cervical cancer she often gets her uterus and cervix removed an operation known as a radical hysterectomy

SOURCES: https://bit.ly/2zgwOfV and https://bit.ly/2zgVXap The New England Journal of Medicine, online October 31, 2018.

Researchers say this applies only to cervical cancer surgery, and minimally invasive surgery can still be a good option for other types of cancers. Doctors estimate that several thousand women in India undergo minimally invasive hysterectomy for early stage cervical cancer or endometrial cancer every year. "Studies had shown that for most cancers, outcomes with less invasive surgery are comparable to open surgery, with the added benefit of fewer short-term postoperative complications".

A second study in the same issue reviewed data on almost 2,500 women and found the risk of death from any cause over up to four years was 65 percent higher with the less-invasive operation.

A hysterectomy was her best option but the 45-year-old orthopedic surgeon had two choices: "Either the traditional, what they call open laparotomy, (in which they) kind of slice you vertically down the front, take everything out, and set you back up and it's a six to eight week recovery", Andersson said. She said Johns Hopkins Hospital in Baltimore has stopped doing less invasive hysterectomies for cervical cancer until there is more data.

"Personally, I will not offer minimally invasive radical hysterectomy to patients who come to me for cervical cancer treatment until compelling new research demonstrates a minimally invasive approach that does not carry these risks", agreed Dr. Alexander Melamed of Massachusetts General Hospital and Harvard Medical School, another member of the study team. Schink has been practicing minimally invasive surgeries for the past 15 years.

EMMA BARBER: I think increasingly that's going to be open surgery for many women, but there may still be a role for a minimally invasive surgery in some patients.

The study did not investigate why minimally invasive hysterectomy might result in a higher mortality rate.

Nigerian army posts Trump video to justify deadly fire
The Nigerian military said three protesters were killed, but the toll appears to have been much higher. In a tweet, which has since been deleted, the Nigerian Army shared a video of Mr.

Taylor Swift Gets Political Again - Condemns ‘Fear-Based Extremism!’
They resisted law enforcement, and they interrupted a moment of silence for the victims in Pittsburgh". She blamed the protests on her Democratic opponent, former Tennessee Gov.

Spinal electrical implants helps three paralyzed men walk
The stimulation begins with a pulse directed at a muscle to prompt the patient to begin movement, for example a step. Nerves in the spinal cord send signals from the brain to the legs.

Initial studies appeared to support the use of the minimally invasive techniques. Compared with open surgery, minimally invasive surgery correlated with a lower rate of disease-free survival (three-year rate, 91.2 versus 97.1 percent; hazard ratio for disease recurrence or death from cervical cancer, 3.74; 95 percent CI, 1.63 to 8.58) and with a lower rate of overall survival (three-year rate, 93.8 versus 99.0 percent; hazard ratio, 6.00; 95 percent CI, 1.77 to 20.30).

Melamed said patients can still opt for the minimally invasive approach, but only after considering the new data. The rate of disease-free survival at 4.5 years was 86 percent with minimally invasive surgery and 96.5 percent with open surgery. "While we need to learn more about the reasons behind these findings, surgeons who wish to offer minimally invasive radical hysterectomy to cervical cancer patients must ensure they are informed of these risks". He wasn't involved in the studies, but agreed they could change clinical practice.

The researchers tracked the surgical outcomes of 2,461 patients in the US National Cancer Database who had radical hysterectomies for early stage cervical cancer from 2010 to 2013.

The research team - including investigators from Brigham and Women's Hospital, Northwestern University Feinberg School of Medicine, Columbia University/New York Presbyterian Hospital, the University of Wisconsin School of Medicine and Public Health, and the University of Texas M.D. Anderson Cancer Center - analyzed information from the National Cancer Database, which covers around 70 percent of newly diagnosed cancer cases from more than 1,500 US hospitals.

One study team looked at almost 2,500 women with stage 1 cervical cancer in 2010-2013.

Dr. Wright receives consulting fees from Clovis Oncology and Tesaro. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the Vagelos College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. For new venture, a practicality examination is given. For more information, visit cumc.columbia.edu or columbiadoctors.org.

NewYork-Presbyterian is one of the nation's most comprehensive, integrated academic healthcare delivery systems, whose organizations are dedicated to providing the highest quality, most compassionate care and service to patients in the NY metropolitan area, nationally, and throughout the globe. In August 2018 the MGH was once again named to the Honor Roll in the U.S. News & World Report list of "America's Best Hospitals". "It's been an unexpected finding for all of us".

Related:

Comments

Latest news

Hearthstone's Next Expansion Is Rastakhan's Rumble
Overkill allows a card or player to receive a certain bonus if they deal more damage to a minion than it requires to kill them. Your minion's Battlecries and Combos will also trigger twice, setting you up for some potentially devastating combos.

Dodgers re-sign David Freese to one-year, $5 million deal
Kershaw, who could've used the opt-out in his contract to become a free agent, has instead agreed to a new pact with Los Angeles. Rosenthal reported Thursday night that Kershaw and the Dodgers were discussing adding a third year to his deal .

Mario's Real-Life Namesake, Mario Segale, Dies At 84
The only time he is understood to have spoken about the character is in an interview in 1993 in the Seattle Times . Mario Segale was clearly a shrewd businessman, working alongside his wife, Donna, and their four children.

Netanyahu Tells Trump To Back Saudi Prince After Brutal Khashoggi Murder
Killing an innocent person is one crime, the treatment and extent of what was done to the body is another crime and dishonour. Saudi Arabia has changed its statement on the events surrounding Khashoggi's disappearance multiple times.

Blizzard Announces Diablo Immortal, A Mobile Game
If you're interested in pre-registering for Diablo: Immortal you can do so here. The Diablo amiibo will work with Diablo III: Eternal Collection .

FP’s Guide to the Bolsonaro Presidency
When Brazil's military dictatorship ended in 1985, the balance of power tipped toward leaders of centrist and leftist leanings. However he was "open to negotiation on that issue".

New True Detective season 3 trailer gives plot details
I'll probably be tuning in for at least the first two episodes if the reviews are solid. Scoot McNairy , Mamie Gummer , and Carmen Ejogo round out the cast.

Royal Visit: Prince Charles Expected In Ghana Today
Clarence House has now announced that the royals will go on to visit Ghana and Nigeria following their brief stay in The Gambia. A state banquet will also be held in their honor.

Tech: Hubble reveals cosmic Bat Shadow in the Serpent's Tail
The planetary system we live in once emerged from a similar protoplanetary disc when the Sun was only a few million years old. One thing many people don't understand about astronomy is that you can learn as much from what you can't see as what you can.

Galaxy ‘mega-merger’ 10 billion years ago forged Milky Way
The Milky Way (white) gobbles up the dwarf galaxy Gaia-Enceladus (red) in scenes from a computer simulation of the ancient event. It shook the Milky Way, changing the structure of the galactic disk, setting off bursts of star formation in its wake.

Dinosaurs Put All Colored Birds' Eggs in One Basket, Evolutionarily Speaking
Before this work, though, many biologists predicted that modern birds, not their ancestors, developed colorful eggshells. Now the researchers have analyzed egg shells from more. "We can fingerprint the pigments", Wiemann said .

Hodgson’s comments suggest Jason Puncheon’s Crystal Palace career is not over yet
The current record is 11 games, held by Frank Clark with Nottingham Forest in 1994 - Sarri now has 10 unbeaten games. He says he is not thinking about breaking the record for an unbeaten start to a Premier League career.

Paris Masters: Roger Federer confirms participation
The 56th-ranked Paire made the opening round through the qualifiers but lost 6-4, 6-4 to Hungary's Marton Fucsovics. Raonic is now ranked 21st in the world.

Nicklas Bendtner sentenced to 50 days in jail in Denmark for assault
Rosenborg have stood behind Bendtner despite expressing their disapproval of his actions. He began his career at Arsenal and scored 45 goals in 171 games for the Gunners.

Chris Cornell's widow sues doctor over Soundgarden singer’s death
Vicky and Cornell Wednesday in 2004 and have two children together, 14-year-old daughter, Toni and 12-year-old son, Christopher. Koblin is a competent and conscientious doctor who enjoyed an excellent physician/patient relationship with Mr.

Other news