Introduction/Background Radical hysterectomy (RH) is recommended as a standard treatment for early stage cervical cancer (FIGO IA1 to IIA2). There is no guideline to recommend either laparoscopy or abdominal laparotomy for treating these patients. Laparoscopic surgery has been increasingly used in this indication since it is associated with less morbidity. However, a recent randomized trial showed that patients treated with minimally invasive surgery experienced higher recurrence rate and a lower overall survival rate. As this is the first and only trial showing such results, we aimed to evaluate oncological and surgical outcomes of these patients treated by minimal invasive surgery or laparotomy for an early stage cervical cancer using a large french multicentric database.
Methodology Data of 1447 patients with cervical cancer treated between 1996 and 2016 were extracted from maintained databases of 10 French University hospitals. Patients treated with RH for an early stage cervical cancer were selected for further analysis.
A propensity score-matched comparison (1:3) was developed through multivariable logistic regression model including age, stage, histological type, tumor size, body mass index and adjuvant therapy as covariates. The primary outcome was overall survival. Secondary outcomes included surgical parameters such as the operating time, blood loss, complication rate and oncological data such as disease free survival and site of recurrence.
Results After performing propensity score matching, 34 patients treated with abdominal surgery were matched with 101 patients treated by minimal invasive surgery. The groups were similar for the main parameters influencing survival in early stage cervical cancer i.e. age, FIGO stage, tumor size and adjuvant therapy received.
The laparoscopic group displayed a poorer overall survival (median OS 32,26 vs 56,88 months ; p<0,05).
Conclusion In this multicenter study, minimal invasive surgery was associated with lower rates of overall survival among patients treated with RH for an early stage cervical cancer.
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.