Introduction/Background The `Laparoscopic Approach to Carcinoma of the Cervix` (LACC) trial (2018), described oncological results in favor of laparotomy compared to minimally invasive surgery (MIS) in the management of early-stage cervical cancer. Aim of our study was to assess the impact of those results on the choice of surgical approach of the Belgian Gynecologic Oncologists.

Methodology An electronic survey using the REDCap platform was sent in December 2020 to 81 individual Belgian Gynecologic Oncologists, consisting of several topics: characteristics of their practice, day-to-day practice and surgical approaches of early-stage cervical cancer, measures to minimize spill during the operation and ratio of the types of procedures (open vs laparoscopic vs robot-assisted), before and after the LACC-trial.

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Abstract #1010 Figure 1

Change of practice in type of surgery to perform radical hysterectomy.

Results Twenty-seven surveys (Response Rate of 33.3%) were collected from January to May 2021. After the LACC-trial, 16 of 25 (64%) individual Belgian Gynecologic Oncologists still performed MIS. Change in type of surgery is shown in figure 1. More than half (56.3%) indicate to having modified their practice when performing a radical hysterectomy (RH) for early-stage cervical cancer, in terms of indication and measures to minimize spill. In order to minimize spill, specific precautions were taken by those performing MIS. The use of a uterine manipulator decreased with about 18% (43 to 25%), the use of a vaginal cuff more than doubled (15 to 62%) and the use of an endobag increased with approximately 44% (56 to 100%).

Conclusion The LACC-trial led to a change in surgical practices for early-stage cervical cancer in Belgium, although still two thirds of the participating Belgian Gynecologic Oncologists perform RH through MIS techniques. This is in contrast with international guidelines. More than half of the responding Belgian Gynecologic Oncologists modified their practice by taking precautions to minimize spill.

Disclosures none