Introduction/Background Traditional management of Stage 1B1 cervical cancer has been the radical hysterectomy. Traditionally this was performed via laparotomy (TARH) although increasingly this has been performed via laparoscopy (TLRH). Two trials have demonstrated worse survival in patients undergoing minimal access radical hysterectomies. Our aim was to review the survival outcomes of women who were treated with radical hysterectomies via either open or laparoscopic routes treated at the University Hospitals of Derby and Burton (UHDB).
Methodology We identified all patients diagnosed with Stage 1B1 Cervical cancer treated with either TARH or TLRH at UHDB with either squamous, adenosquamous and adenocarcinoma histology. A propensity scored analysis was performed to compare 5-year overall survival (OS) and progression-free survival (PFS), and Disease specific survival (DFS) with matching for Grade and Histological Subtype.
Results 110 patients were identified between 1/11/00–17/8/19. Of these patients 63(57%) underwent TARH and 47(43%) TLRH. OS was 91.2% in those receiving TARH compared to 100% in those receiving TLRH. PFS was 86% in those receiving TARH arm compared to 97.6% in those receiving TLRH. DFS was 94.7% in those receiving TARH arm compared to 100% in those receiving TLRH.
A propensity score was performed to match 47 TLRH patients with 47 TARH patients. Overall survival was greatest for those women who underwent TLRH compared to TARH (100% versus 89% respectively, P=0.12). PFS was greatest in women who had undergone TLRH (98%) compared to TARH (80%). Women who had undergone TLRH had DFS of 100% compared to 90% of those women who had TARH.
Conclusion In contrast to two recent studies our data demonstrates a higher 5-year OS and 5 year PFS following TLRH compared to TARH. We wonder if other issues such as laparoscopic surgical technique or differences in tumour biology/patient factors may explain the findings of the LACC trial.
Disclosure Nothing to disclose.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.