Klin Onkol 2025; 38(3): 201-208. DOI: 10.48095/ccko2025201.
Background: Total mesometrial resection (TMMR) has shown excellent locoregional control for treatment of cervical cancer without adjuvant radiation therapy in highly selected centers. However, this procedure was never evaluated in resource-limited setting. We hypothesized that the procedure can be reproduced outside the university centers without compromising results. Materials and methods: This is a retrospective, observational, multicenter cohort study of patients with IB1–IIB cervical cancer who underwent TMMR in developing countries and omitted adjuvant radiation therapy. Results: A total of 124 patients who met the inclusion criteria were identified between 2015 and 2024 in three centers. The median follow-up was 29 months. The relapse rate was 6.1% (2 out of 33) for IB1, 3% (1 out of 33) for IB2, 11.1% (2 out of 18) for IB3, 20% (1 out of 5) for IIA1, and 16% (6 out of 24) for node-positive patients. No relapses were detected among IIA2 and IIB stages (3 and 8 patients, respectively). There was no significant difference (P = 0.36) in the relapse rate between patients who met the Sedlis criteria (2.9%) and those who did not (8.8%). Conclusion: According to the study, TMMR outcomes can be reproduced without compromising oncologic outcomes. However, prospective evaluation, longer follow-up and a larger cohort are needed to confirm these preliminary data.