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Multicenter Study
. 2022 Sep;166(3):417-424.
doi: 10.1016/j.ygyno.2022.07.002. Epub 2022 Jul 22.

The MEMORY Study: MulticentEr study of Minimally invasive surgery versus Open Radical hYsterectomy in the management of early-stage cervical cancer: Survival outcomes

Mario M Leitao Jr  1 , Qin C Zhou  2 , Benny Brandt  3 , Alexia Iasonos  2 , Vasileios Sioulas  3 , Katherine Lavigne Mager  3 , Mark Shahin  4 , Shaina Bruce  4 , Destin R Black  5 , Carrie G Kay  6 , Meeli Gandhi  7 , Maira Qayyum  7 , Jennifer Scalici  8 , Nathaniel L Jones  8 , Rajesh Paladugu  8 , Jubilee Brown  9 , R Wendel Naumann  9 , Monica D Levine  9 , Alberto Mendivil  10 , Peter C Lim  11 , Elizabeth Kang  11 , Leigh A Cantrell  12 , Mackenzie W Sullivan  12 , Martin A Martino  13 , Melissa K Kratz  13 , Valentin Kolev  14 , Shannon Tomita  14 , Charles A Leath 3rd  15 , Teresa K L Boitano  15 , David W Doo  15 , Colleen Feltmate  16 , Ronan Sugrue  16 , Alexander B Olawaiye  17 , Ester Goldfeld  17 , Sarah E Ferguson  18 , Jessa Suhner  19 , Nadeem R Abu-Rustum  20
Affiliations
Multicenter Study

The MEMORY Study: MulticentEr study of Minimally invasive surgery versus Open Radical hYsterectomy in the management of early-stage cervical cancer: Survival outcomes

Mario M Leitao Jr et al. Gynecol Oncol. 2022 Sep.

Abstract

Objective: The Laparoscopic Approach to Cervical Cancer (LACC) trial found that minimally invasive radical hysterectomy compared to open radical hysterectomy compromised oncologic outcomes and was associated with worse progression-free survival (PFS) and overall survival (OS) in early-stage cervical carcinoma. We sought to assess oncologic outcomes at multiple centers between minimally invasive (MIS) radical hysterectomy and OPEN radical hysterectomy.

Methods: This is a multi-institutional, retrospective cohort study of patients with 2009 FIGO stage IA1 (with lymphovascular space invasion) to IB1 cervical carcinoma from 1/2007-12/2016. Patients who underwent preoperative therapy were excluded. Squamous cell carcinoma, adenocarcinoma, and adenosquamous carcinomas were included. Appropriate statistical tests were used.

Results: We identified 1093 cases for analysis-715 MIS (558 robotic [78%]) and 378. OPEN procedures. The OPEN cohort had more patients with tumors >2 cm, residual disease in the hysterectomy specimen, and more likely to have had adjuvant therapy. Median follow-up for the MIS and OPEN cohorts were 38.5 months (range, 0.03-149.51) and 54.98 months (range, 0.03-145.20), respectively. Three-year PFS rates were 87.9% (95% CI: 84.9-90.4%) and 89% (95% CI: 84.9-92%), respectively (P = 0.6). On multivariate analysis, the adjusted HR for recurrence/death was 0.70 (95% CI: 0.47-1.03; P = 0.07). Three-year OS rates were 95.8% (95% CI: 93.6-97.2%) and 96.6% (95% CI: 93.8-98.2%), respectively (P = 0.8). On multivariate analysis, the adjusted HR for death was 0.81 (95% CI: 0.43-1.52; P = 0.5).

Conclusion: This multi-institutional analysis showed that an MIS compared to OPEN radical hysterectomy for cervical cancer did not appear to compromise oncologic outcomes, with similar PFS and OS.

Keywords: Cervical cancer; LACC; Laparoscopic Approach to Cervical Cancer trial; Minimally invasive radical hysterectomy; Radical hysterectomy.

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Conflict of interest statement

Declaration of Competing Interest Dr. Leitao is an ad hoc speaker for Intuitive Surgical, Inc.; outside the submitted work, he is on the Advisory Board of Ethicon/Johnson & Johnson and Takeda; and reports grants paid to the institution by KCI/Acelity. Dr. Martino is a patient safety consultant for Intuitive Surgical, Inc. and Medtronic. Outside the submitted work, Dr. Iasonos reports consulting fees from Mylan; Dr. Abu-Rustum reports institutional grants from GRAIL; Dr. Shahin is a speaker/consultant for GSK/Tesaro, AstraZeneca, and Merck, and consultant for Biom'up and Aspira. All other authors have no potential conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Progression-free survival (PFS) for the minimally invasive surgery (MIS) and OPEN cohorts
Figure 2.
Figure 2.
Overall survival (OS) for the minimally invasive surgery (MIS) and OPEN cohorts
See this image and copyright information in PMC

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