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Surgical and Pathological Outcomes of Laparoscopic Versus Abdominal Radical Hysterectomy With Pelvic Lymphadenectomy and/or Para-aortic Lymph Node Sampling for Bulky Early-Stage Cervical Cancer
  1. Tao Zhu, BS*,
  2. Xi Chen, MS*,
  3. Jianqing Zhu, BS*,
  4. Yaqing Chen, MS*,
  5. Aijun Yu, MS*,
  6. Lu Chen, MS*,
  7. Huafeng Shou, MS*,
  8. Meijuan Wu, MS and
  9. Ping Zhang, BS*
  1. * Departments of Gynecological Oncology and
  2. Histopathology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China.
  1. Address correspondence and reprint requests to Ping Zhang, BS, Department of Gynecological Oncology, Zhejiang Cancer Hospital, 38 Guangji Rd, Banshan Bridge, Hangzhou, Zhejiang 310022, China. E-mail: zhangping{at}zjcc.org.cn.

Abstract

Background and Objectives The aim of this study was to compare the feasibility, morbidity, and recurrence rate of total laparoscopic radical hysterectomy (LRH) with those of abdominal radical hysterectomy (ARH) for bulky early-stage cervical cancer.

Methods We performed a retrospective cohort study of 112 patients with stage IB1 or IIA2 cervical cancer in which the tumor diameter was 3 cm or greater. All patients underwent LRH (n = 30) or ARH (n = 82) with pelvic lymphadenectomy and/or para-aortic lymph node sampling between May 2011 and November 2014. Perioperative outcomes were compared between the 2 surgical groups.

Results The laparoscopic approach consisted of 4 trocar insertions. Age, tumor diameter, and pelvic lymph nodes significantly differed between the 2 cohorts. Body mass index, International Federation of Gynecology and Obstetrics stage, histologic type and grade, deep stromal invasion, lymphovascular space invasion, positive margins, and adjuvant therapy were not significantly different between the 2 cohorts. Laparoscopic radical hysterectomy exhibited favorable results compared with ARH in terms of operating time, blood loss, intestinal exhaust time, and length of hospital stay. In addition, recurrence was observed in 5 LRH patients (16.7%) and 9 ARH patients (11.7%).

Conclusions The surgical outcomes of LRH with pelvic lymphadenectomy and/or para-aortic lymph node sampling exhibited a similar therapeutic efficacy to those of the ARH approach.

  • Abdominal radical hysterectomy
  • Cervical cancer
  • Laparoscopic radical hysterectomy
  • Pelvic lymphadenectomy

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Footnotes

  • The authors declare no conflicts of interest.

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