Introduction/Background To investigate the impact of laparoscopic surgery on short- and medium-term outcomes of cervical cancer patients undergoing nerve-sparing radical hysterectomy.
Methodology Data of consecutive patients affected by locally-advaced cervcial cancer who had neoadjuvant chemotherapy followed by laparoscopic nerve-sparing radical hysterectomy were matched 1:1 with an historical cohort of patients undergoing neoadjuvant chemotherapy followed by open radical hysterectomy, using propensity matching algorithm.
Results Thirty-five patients’ pairs (70 patients: 35 undergoing laparoscopic vs. 35 undergoing open abdominal nerve-sparing radical hysterectomy) were included. Demographic and baseline oncologic characteristics were balanced between groups. Patients undergoing laparoscopic surgery had similar operative time than patients undergoing open abdominal procedures (249 [±91.5] vs. 223 [±65.0] minutes; p=0.066). Laparoscopic approach correlated with lower blood loss (30.5 [±11.0] vs. 190 [90.4] mL; p<0.001) and shorter hospital stay (3.2 [±1.2] vs. 5.4 [2.0] days; p=0.023). Patients undergoing laparoscopy experienced a lower 30-day pelvic floor dysfunction rate than patients having open surgery (p=0.024). Moreover, they experienced shorter recovery of bladder function than patients having open procedures (median, 7 vs. 9 days; p=0.004, log-rank test). After a median follow-up of 51.7 and 14.7 months for open abdominal and minimally invasive procedures, disease-free (p=0.617) and overall (p=0.814) survivals were similar between groups. Using multivariate model, we observed that the adoption of laparoscopic approach did not impact on disease-free (HR: 1.32 (95%CI: 0.58, 3.01); p=0.50) and overall (HR: 1.26 (95%CI: 0.41, 3.81); p=0.67) survivals.
Conclusion Laparoscopic nerve sparing radical hysterectomy resulted in improved short-term outcomes, without impacting on medium-term oncologic outcomes. Further prospective trials are needed to assess long-term outcomes of patients having minimally invasive surgery.
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.