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Long-Term Oncological Outcomes After Laparoscopic Versus Abdominal Radical Hysterectomy in Stage IA2 to IIA2 Cervical Cancer: A Matched Cohort Study
  1. Wei Wang, MD*,
  2. Hong Juan Chu, MD,
  3. Chun Liang Shang, PhD*,
  4. Xiao Gong, PhD,
  5. Tian Yu Liu, PhD*,
  6. Yun He Zhao, MD*,
  7. Jia Ming Huang, MD* and
  8. Shu-zhong Yao, MD*
  1. *Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University;
  2. Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Southern Medical University; and
  3. Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
  1. Address correspondence and reprint requests to Shu-zhong Yao, MD, Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Zhongshan Second Road 58, Guangzhou 510700, PR China. E-mail: yszlfy@163.com.

Abstract

Objective The aim of the study was to investigate the long-term oncological outcomes of laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for treatment of stage IA2 to IIA2 cervical cancer.

Methods We matched stage IA2 to IIA2 cervical cancer patients with known risk factors for recurrence who underwent ARH or LRH.

Results After matching, a total of 203 patient pairs (LRH-ARH) were included. The LRH and ARH group had similar 5-year recurrence-free survival (RFS) rates (91.3% vs 90.4%, P = 0.83) and overall survival (OS) rates (93.2% vs 92.1%, P = 0.94). Patients with different tumor size (⩽2, 2–4, >4 cm) had similar 5-year OS and RFS. Even in patients with pelvic lymph node metastasis, the 5-year RFS (69.20% vs 69.20%, P = 0.87) and OS (77.4% vs 76.3%, P = 0.83) did not differ statistically between the 2 groups. The LRH and ARH group had similar mean time to recurrence (16.29 vs 22.15 months, P = 0.68) and pattern of recurrence (P = 0.63). Compared with ARH, LRH resulted in significantly shorter operating time, less blood loss, and shorter hospital stay. The intraoperative complications rate was similar between the 2 groups (P = 0.72). The rate of postoperative complications was significantly lower in the LRH group than in the ARH group (P = 0.004).

Conclusions Laparoscopic radical hysterectomy was associated with fewer operating time, blood loss, postoperative complication, and earlier recovery. Laparoscopic radical hysterectomy is an oncologically safe alternative to ARH.

  • Cervical cancer
  • Oncological outcomes
  • Laparoscopic radical hysterectomy
  • Abdominal radical hysterectomy

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Footnotes

  • Supported by the Sun Yat-sen University Clinical Research 5010 Program (Grant Number 2007010), the Guangdong Natural Science Fund (Grant Number S2013010015448), and the Science and Technology Program of Guangzhou (Grant Number 201510010289).

  • The authors declare no conflicts of interest.

  • W.W. and H.J.C. contributed equally to this article.

  • Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ijgc.net).

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