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#427 Ten-year outcomes following laparoscopic and open abdominal radical hysterectomy for ‘low-risk’ early-stage cervical cancer: a propensity-score based analysis
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  1. Tullio Golia D’augè1,
  2. Violante Di Donato1,
  3. Giorgio Bogani2,
  4. Jvan Casarin3,
  5. Fabio Ghezzi3,
  6. Mario Malzoni4,
  7. Francesca Falcone4,
  8. Marco Petrillo5,
  9. Giampiero Capobianco5,
  10. Filippo Calò1,
  11. Ludovico Muzii1,
  12. Pierluigi Benedetti Panici1,
  13. Elisa Ervas3,
  14. Antonino Ditto2,
  15. Francesco Raspagliesi2,
  16. Francesco Sopracordevole6,
  17. Enrico Vizza7 and
  18. Andrea Giannini1
  1. 1Department of Gynecological, Obstetrical and Urological Sciences, ‘Sapienza’ University of Rome, Italy, Rome, Italy
  2. 2Gynecological Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy, Milan, Italy
  3. 3Department of Obstetrics and Gynecology, ‘Filippo Del Ponte’ Hospital, University of Insubria, Varese, Italy, Varese, Italy
  4. 4Endoscopica Malzoni, Center for Advanced Endoscopic Gynecological Surgery, Avellino, Italy, Avellino, Italy
  5. 5Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy., Sassari, Italy
  6. 6Gynecologic Oncology Unit, Centro di Riferimento Oncologico (CRO) – Aviano, Aviano Italy, Milan, Italy
  7. 7Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCSS-Regina Elena National Cancer Institute, Rome, Italy, Milan, Italy

Abstract

Introduction/Background Accumulating evidence suggested the detrimental effects of adopting minimally invasive surgery in the management of early-stage cervical cancer. However, long-term evidence on the role of minimally invasive radical hysterectomy in ‘low-risk’ patients exists.

Methodology This is multi-institutional retrospective study comparing minimally invasive and open radical hysterectomy in low-risk early-stage cervical cancer patients. A propensity-score matching algorithm (1:2) was used to allocate patients into the study groups. Kaplan-Meir model was used to estimate 10-year progression-free and overall survival.

Results Charts of 224 ‘low-risk’ patients were retrieved. Overall, 50 patients undergoing radical hysterectomy were matched with 100 patients undergoing open radical hysterectomy. Minimally invasive radical hysterectomy was associated with a longer median operative time (224 (range, 100–310) vs. 184 (range, 150240) minutes; p<0.001), lower estimated blood loss (10 (10–100) vs. 200 (100–1000) ml, p<0.001), and shorter length of hospital stay (3.8 (3–6) vs. 5.1 (4–12); p<0.001). Surgical approach did not influence the risk of having intra-operative (4% vs. 1%; p=0.257) and 90-day severe (grade 3+) postoperative complication rates (4% vs. 8%; p=0.497). Ten-year disease-free survival was similar between groups (94% vs. 95%; p=0.812; HR:1.195;

95%CI:0.275, 5.18). Ten-year overall survival was similar between groups (98% vs. 96%; p=0.995; HR:0.994; 95%CI:0.182, 5.424).

Abstract #427 Figure 1

Study design

Conclusion Our study appears to support emerging evidence suggesting that, for low-risk patients, laparoscopic radical hysterectomy does not result in worse 10-year outcomes compared to the open approach. However, further research is needed and open abdominal radical hysterectomy remains the standard treatment for cervical cancer patients.

Disclosures None.

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