Wednesday, 21 November, 2018

For cervical cancer, minimally invasive surgery may be less effective

Minimally Invasive Minimally Invasive Surgery Is Standard for Cervical Cancer. But A New Study Shows It's Not Effective
Celia Hoffman | 03 November, 2018, 04:46

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Keyhole surgery seemed like a no-brainer to Jeanine Andersson when she was diagnosed with cervical cancer previous year.

Some hospitals went back to traditional hysterectomy after the results were presented at a cancer meeting in March.

"If you find the doctor who is comfortable doing the laparoscopic procedure, I think the outcomes would be just as good as with open surgery", he said. Tests following her September operation show no signs of cancer.

However, two new studies could change all that.

Cervical cancer is due to the abnormal growth of cells in the cervix that have the ability to invade or spread to other parts of the body.

Two studies out today raised concerns about a treatment for early stage cervical cancer that had gained favor in the U.S. The studies, published online in the New England Journal of Medicine, say minimally invasive surgery is actually worse for women than standard surgery.

"This (new) result is very surprising, since randomised trials have demonstrated the safety of minimally invasive surgery for uterine, gastric and colorectal cancers", Alexander Melamed, a gynaecologic oncologist at the Massachusetts General Hospital in the U.S. and lead author of one of the studies, said in a media release.

In minimally invasive hysterectomy, surgeons make small incisions or punctures and use instruments called laparoscopes or robotic devices to remove the uterus. It usually leads to less bleeding, fewer infections and fewer complications.

Additionally, Schink said patients should remember that the study focused exclusively on cervical cancer, which is just one type of gynecological cancer.

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THURSDAY, Nov. 1, 2018 (HealthDay News) - For patients with early-stage cervical cancer, minimally invasive surgery is associated with increased mortality and worse survival than open surgery, according to two studies published online October 31 in the New England Journal of Medicine.

RAMIREZ: Patients who underwent the minimally invasive surgery had four times greater likelihood of returns than when they had the surgery through the open approach. Additionally, the global Minimally Invasive Spine Surgery market report covers the major product categories and segments Implants and instrumentation, Biomaterials along with their sub-segments Spine fusion procedure, Spine non-fusion procedure in detail.

Results were published Wednesday by the New England Journal of Medicine. The study involved more than 600 women recruited at medical centers worldwide. Their results showed that the rate of disease-free survival after four years was 90.9% for the minimally invasive surgery group and 94.7% for the open surgery group.

That was the surprising result of a study he co-authored comparing the minimally invasive approach with standard surgery though a large incision. Embracing minimally-invasive surgery reversed that trend "and coincided with the beginning of a decline in the 4-year survival rate of 0.8 percent per year between 2006 and 2010", Wright's team reports in their paper.

While some patients with small tumors might do as well with minimally invasive surgery, "surgeons should proceed cautiously" and discuss the new information with patients, Fader wrote in an accompanying editorial.

"It's important to note that our study doesn't explain why mortality is higher among women who have minimally invasive surgery", says Melamed, who is a clinical fellow in Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School. Ramirez says surgeons at MD Anderson immediately changed their treatment for early cervical cancer. So Andersson is being treated with radiation and chemotherapy. "Our own work using similar methods to investigate minimally invasive surgery for ovarian cancer found no association with increased mortality, so it seems clear that something very different may be going on in cervical cancer".

"Surgeons who wish to offer minimally invasive radical hysterectomy to cervical cancer patients must ensure they are informed of these risks", Melamed said.

Scope of the Minimally Invasive Medical Robotics Market Report: Geographically, the market is splitted into various key Regions including North America, Europe, Asia-Pacific, South America, Middle East & Africa on the basis of revenue (million USD), growth rate, market share (%), production, and consumption from 2018 to 2025 (forecast). "So in other words we use gas, it's usually carbon dioxide gas, to inflate the abdomen so that we can see the surgical field", said Dr. Pedro Ramirez, a professor in gynecologic oncology at MD Anderson who also worked on the study and who treated Andersson.

Surgical skill may also be a factor, said Melamed. The surgery costs around $9,000 to $12,000 with the minimally invasive version at the higher end.

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