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442 Should we really abandon minimally invasive surgery in early-stage cervical cancer? oncological results of laparoscopically assisted radical vaginal hysterectomy
  1. Ariel Gustavo Glickman1,
  2. Jaume Pahisa1,
  3. Blanca Gil Ibanez2,
  4. Berta Diaz-Feijoo1,
  5. Pere Fusté1,
  6. Núria Carreras3,
  7. Núria Agustí3,
  8. Lydia Gaba3,
  9. Marta Del Pino4 and
  10. Aureli Torne1
  1. 1Hospital Clínic Barcelona; Gynaecological Oncology Unit
  2. 2Gynecological Oncology and Endoscopy Unit. Gynecology and Obstetrics Department. University Hospital 12 de Octubre. Madrid. Spain. Research Institute I+12. University Hospital 12 de Octubre. Madrid
  3. 3Hospital Clínic Barcelona
  4. 4Hospital Clínic; Hospital Clínic Barcelona; Gynaecology


Introduction/Background Recent evidence indicates that some minimally invasive surgery (MIS) approaches, such as laparoscopic- and robotic-assisted radical hysterectomy, offer lower survival rates to patients with early-stage cervical cancer compared with open radical hysterectomy. We evaluated the oncological results of a different MIS approach, that of laparoscopically assisted radical vaginal hysterectomy (LARVH) in the treatment of patients with early-stage cervical cancer.

Methodology From January 2001 to December 2018, patients with early-stage cervical cancer (IA1 with lymphovascular invasion, IA2, IB1, and IIA < 2 cm; FIGO 2009) were treated by LARVH. Colpotomy and initial closure of the vagina were performed following the Schauta procedure, avoiding manipulation of the tumor. Laparoscopic sentinel lymph node (SLN) biopsy was performed in all cases. Women treated between 2001 and 2011 also underwent systematic bilateral pelvic lymphadenectomy after SLN biopsy. Adjuvant radiotherapy or chemo-radiotherapy was administered according to standard guidelines.

Results One hundred fifteen patients were included. Intraoperative complications occurred in nine patients (7.8%). Adjuvant radiotherapy or chemoradiotherapy was administered to 35 (30.4%) and three (2.6%) patients, respectively. After a median follow-up of 87.8 months (range 1–216), seven women (6%) presented recurrence (three pelvic and two paraaortic recurrences, and two had distant metastases). Four women died (mortality rate 3.4%). The three and 4.5-year disease-free survival rates were 96.7% and 93.5%, respectively, and the overall survival was 97.8% and 94.8%, respectively.

Conclusion LARVH offers excellent disease-free and overall survival in women with early stage cervical cancer and can be considered as an adequate MIS alternative to open radical hysterectomy.

Disclosures No disclosures to declare.

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