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PR006/#38  Ten-year outcomes following laparoscopic and open abdominal radical hysterectomy for ‘low-risk’ early-stage cervical cancer: a propensity-score based analysis
  1. Giorgio Bogani1,
  2. Francesco Raspagliesi1,
  3. Mario Malzoni2,
  4. Mariangela Longo1,
  5. Elisa Ervas3,
  6. Jvan Casarin4,
  7. Francesco Plotti5,
  8. Roberto Angioli5,
  9. Ilaria Cuccu6,
  10. Camilla Turetta6,
  11. Tullio Golia D’Auge6 and
  12. Violante Di Donato7
  1. 1Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Gynecologic Oncology, Milano, Italy
  2. 2Malzoni Medical Center, Gynecology, Avellino, Italy
  3. 3National Cancer Institute, Gynecologic Oncology, Milano, Italy
  4. 4University of Insubria, Gynecologic Oncology Unit, Varese, Italy
  5. 5Campus Biomedico, Gynecology, Roma, RM, Italy
  6. 6University La Sapienza, Gynecologic Oncology Unit, Roma, RM, Italy
  7. 7University La Sapienza, Gynecologic Oncology Unit, Rome, Italy


Introduction 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.

Methods This multi-institutional retrospective study compared minimally invasive and open radical hysterectomies 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, 150–240) 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). The 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).

Conclusion/Implications 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.

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