Introduction/Background After LACC trial results, there is controversy about surgical approach in early stage cervical cancer. The aim of this study is to compare morbidity and mortality, as well as disease recurrence using two different techniques at our centre, Hospital Clínico San Carlos.
Methodology Historical Cohort Study of women who underwent surgery in the initial stage of cervical cancer by total or radical hysterectomy +- lymphadenectomy. 53 patients operated on by laparotomy from 2000–2009 (group A) were compared with 53 patients operated on endoscopically (laparoscopic or robotic surgery) from 2009–2018 (group B).
Results Both groups were homogeneous. Intra-operative complications were more frequent in Group B (p=0,045) but no differences in post-operative complications were found. Although reinterventions were scarce, they were performed later in laparotomy, while immediate re-operations were more frequent in group B (p=0.02). Postoperative recovery was faster after an endoscopic approach, leading to shorter hospital stays (p<0,05). Group A had 16% tumoral recurrence compared to 20% in Group B. There was no significant difference in disease-free survival (DFS) at 5 years, with 87% for laparotomy versus 77% for the endoscopic approach. Mortality in early stage cervical cancer was extremely low in both groups, with no significant difference with regard to surgical approach.
Conclusion Early stage cervical cancer can be treated by laparoscopy or laparotomy. Although there were no differences in total mortality, DFS appeared to be higher when laparotomy was used. Despite the fact that the endoscopic approach had higher immediate reoperation rates, hospital stays were significantly shorter and subsequent complication rates were lower. Thus, surgical approach should be a surgeon’s choice.
Disclosure Nothing to disclose.
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