Surgical and oncologic outcomes between laparoscopic and radical abdominal hysterectomy for IB1-IIA2 cervical cancer

Objective: To compare sugrical and survival outcomes between laparoscopic radical hysterectomy (LRH) and radical abdominal hysterectomy (RAH).Methods: All the patients with IB1-IIA2 cervical cancer who performed LRH or RAH in Fudan University Shanghai Cancer Center between 1/2016 and 12/2017 were retrospectively analyzed.Results: There were no significant differences between LRH and RAH groups except deep stromal in-vasion (35.2% vs 54.4%, p = 0.000), operating time (232.3 +/- 61.9 min vs. 106.7 +/- 36.2 min, p = 0.000), blood loss (169.5 +/- 96.2 ml vs. 219.6 +/- 149.3 ml, p = 0.000), and lymph node counts (21.1 +/- 7.1 vs. 23.2 +/- 8.7 min, p = 0.012). The LRH group displayed poorer disease-free survival (DFS) (5-year rate, 79.4% vs. 90.0%; p = 0.046) and overall survival (OS) (5-year rate, 74.7% vs. 90.0%; p = 0.026) compared to the RAH group. On multivariate analysis, LRH was an independent risk factor for DFS (hazard ratio, 0.377; 95% confidence interval [CI], 0.227-0.625; p = 0.000) and OS (hazard ratio, 0.434; 95% CI, 0.254-0.740; p = 0.003).Conclusions: LRH affected the survival of cervical cancer patients with tumor size >2 cm (p < 0.05). Adjuvant therapy could not improve the prognosis of laparoscopic patients (p < 0.05).(c) 2022 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).