{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:11:17Z","timestamp":1790187077602,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Cervical cancer is a common gynecological malignancy. In addition to the open radical hysterectomy (ORH) and laparoscopic radical hysterectomy (LRH), laparoscopic nerve-sparing radical hysterectomy (LNSRH) could be another treatment option since it could preserve urinary, colorectal, and sexual functions. However, LNSRH might result in early cancer metastasis and recurrence due to inadequate tumor resection. Additionally, whether LNSRH should be considered based on perineural invasion (PNI) status remains controversial. To assess different types of hysterectomy on the outcome of early cervical cancer with PIN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was performed in early cervical cancer patients who received ORH, LRH, or LNSRH between January 2012 and December 2019. Age, FIGO cancer stages, histopathological types, tumor size, histological grade, invasion depth, lymph node metastasis, lymphovascular space invasion, and PNI were documented. Disease-free survival (DFS) and overall survival (OS) were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 174 patients were included, with 33, 69, and 72 patients received LRH, ORH, and LNSRH, respectively. Twenty-one patients (12.1%) had PNI. DFS (<jats:italic>P<\/jats:italic> = 0.000) and OS (<jats:italic>P<\/jats:italic> = 0.022) periods were shortened in positive PNI patients than in negative PNI patients (<jats:italic>P<\/jats:italic> = 0.000 and 0.022, respectively). In patients with positive PNI, lymph node metastasis, but not the surgery type, was an independent risk factor for DFS and OS (<jats:italic>P<\/jats:italic> = 0.000).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early cervical cancer patients with PNI had shorter postoperative DFS and OS periods. In these patients, lymph node metastasis, but not the type of hysterectomy, was independently associated with DFS and OS.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2022.889862","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T13:47:37Z","timestamp":1651240057000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Survival Impacts of Perineural Invasion on Patients Under Different Radical Hysterectomies Due to Early Cervical Cancer"],"prefix":"10.3389","volume":"12","author":[{"given":"Wei-wei","family":"Wei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huihui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ru-xia","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30482-6","article-title":"Estimates of Incidence and Mortality of Cervical Cancer in 2018: A Worldwide Analysis","volume":"8","author":"Arbyn","year":"2020","journal-title":"Lancet Glob Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.ejca.2020.04.006","article-title":"Survival of Patients With Early-Stage Cervical Cancer After Abdominal or Laparoscopic Radical Hysterectomy: A Nationwide Cohort Study and Literature Review","volume":"133","author":"Wenzel","year":"2020","journal-title":"Eur J Cancer"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806395","article-title":"Minimally Invasive Versus Abdominal Radical Hysterectomy for Cervical Cancer","volume":"379","author":"Ramirez","year":"2018","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1804923","article-title":"Survival After Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer","volume":"379","author":"Melamed","year":"2018","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1016\/j.jmig.2020.12.023","article-title":"Minimally Invasive Radical Hysterectomy for Cervical Cancer: A Systematic Review and Meta-Analysis","volume":"28","author":"Smith","year":"2021","journal-title":"J Minim Invasive Gynecol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.1694","article-title":"Survival After Minimally Invasive vs Open Radical Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis","volume":"6","author":"Nitecki","year":"2020","journal-title":"JAMA Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-021-02632-7","article-title":"Sexual, Bladder and Bowel Function Following Different Minimally Invasive Techniques of Radical Hysterectomy in Patients With Early-Stage Cervical Cancer","volume":"23","author":"Baessler","year":"2021","journal-title":"Clin Transl Oncol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1186\/s12957-021-02408-x","article-title":"Laparoscopic Nervesparing Radical Hysterectomy for the Treatment of Cervical Cancer: A Meta-Analysis of Randomized Controlled Trials","volume":"19","author":"Ma","year":"2021","journal-title":"World J Surg Oncol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e49","DOI":"10.3802\/jgo.2020.31.e49","article-title":"Nerve-Sparing Radical Hysterectomy in the Precision Surgery for Cervical Cancer","volume":"31","author":"Sakuragi","year":"2020","journal-title":"J Gynecol Oncol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"203","DOI":"10.21037\/atm.2019.04.35","article-title":"Perineural Invasion in Cervical Cancer: Pay Attention to the Indications of Nerve-Sparing Radical Hysterectomy","volume":"7","author":"Zhu","year":"2019","journal-title":"Ann Transl Med"},{"key":"B11","first-page":"1","article-title":"Perineural Invasion of Cancer: A Complex Crosstalk Between Cells and Molecules in the Perineural Niche","volume":"9","author":"Chen","year":"2019","journal-title":"Am J Cancer Res"},{"key":"B12","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.cytogfr.2009.11.001","article-title":"Molecular Mechanisms of Perineural Invasion, a Forgotten Pathway of Dissemination and Metastasis","volume":"21","author":"Marchesi","year":"2010","journal-title":"Cytokine Growth Factor Rev"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2018.8116","article-title":"Perineural Invasion in Early-Stage Cervical Cancer and its Relevance Following Surgery","volume":"15","author":"Zhu","year":"2018","journal-title":"Oncol Lett"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2018.9674","article-title":"Perineural Invasion as a Prognostic Risk Factor in Patients With Early Cervical Cancer","volume":"17","author":"Tang","year":"2019","journal-title":"Oncol Lett"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-015-3627-z","article-title":"Perineural Invasion as a Prognostic Factor for Cervical Cancer: A Systematic Review and Meta-Analysis","volume":"292","author":"Cui","year":"2015","journal-title":"Arch Gynecol Obstet"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000577","article-title":"Laparoscopic Nerve-Sparing Radical Hysterectomy for Cervical Carcinoma: Emphasis on Nerve Content in Removed Cardinal Ligaments","volume":"26","author":"Shi","year":"2016","journal-title":"Int J Gynecol Cancer"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0b013e318257df5f","article-title":"Prognostic Significance of Perineural Invasion in Cervical Cancer","volume":"32","author":"Cho","year":"2013","journal-title":"Int J Gynecol Pathol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.03.025","article-title":"A Nomogram Predicting the Risks of Distant Metastasis Following Postoperative Radiotherapy for Uterine Cervical Carcinoma: A Korean Radiation Oncology Group Study (KROG 12-08)","volume":"111","author":"Je","year":"2014","journal-title":"Radiother Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2004.11.007","article-title":"Rethinking the Use of Radiation and Chemotherapy After Radical Hysterectomy: A Clinical-Pathologic Analysis of a Gynecologic Oncology Group\/Southwest Oncology Group\/Radiation Therapy Oncology Group Trial","volume":"96","author":"Monk","year":"2005","journal-title":"Gynecol Oncol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2005.10.019","article-title":"A Phase III Randomized Trial of Postoperative Pelvic Irradiation in Stage IB Cervical Carcinoma With Poor Prognostic Features: Follow-Up of a Gynecologic Oncology Group Study","volume":"65","author":"Rotman","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24396","article-title":"Perineural Invasion in Cancer: A Review of the Literature","volume":"115","author":"Liebig","year":"2009","journal-title":"Cancer"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000006","article-title":"Hysterectomy for the Treatment of Gynecologic Malignancy","volume":"57","author":"Backes","year":"2014","journal-title":"Clin Obstet Gynecol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.3802\/jgo.2021.32.e10","article-title":"Total Laparoscopic vs. Conventional Open Abdominal Nerve-Sparing Radical Hysterectomy: Clinical, Surgical, Oncological and Functional Outcomes in 301 Patients With Cervical Cancer","volume":"32","author":"Ceccaroni","year":"2021","journal-title":"J Gynecol Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2016.941","article-title":"Evaluation of the Association Between Perineural Invasion and Clinical and Histopathological Features of Cervical Cancer","volume":"5","author":"Wei","year":"2016","journal-title":"Mol Clin Oncol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2020-001506","article-title":"SUCCOR Study: An International European Cohort Observational Study Comparing Minimally Invasive Surgery Versus Open Abdominal Radical Hysterectomy in Patients With Stage IB1 Cervical Cancer","volume":"30","author":"Chiva","year":"2020","journal-title":"Int J Gynecol Cancer"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000001254","article-title":"Comparison of Different Surgical Approaches for Stage Ib1 Cervical Cancer Patients: A Multi-Institution Study and a Review of the Literature","volume":"28","author":"Corrado","year":"2018","journal-title":"Int J Gynecol Cancer"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.889862\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T13:47:41Z","timestamp":1651240061000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.889862\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,29]]},"references-count":26,"alternative-id":["10.3389\/fonc.2022.889862"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2022.889862","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,29]]},"article-number":"889862"}}