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Abstract
Introduction The impact of the LACC trial’s results on oncologic outcome has not been assessed. This study aimed to compare 2-year recurrence-free survival before and after the LACC trial for cervical cancer patients undergoing surgical treatment.
Methods Cervical cancer patients who underwent radical hysterectomy and pelvic lymphadenectomy at the European Institute of Oncology, Milan from January 2010 to December 2021 were retrospectively identified. Following the LACC trial’s results, robotic-assisted surgery was limited to patients with no residual disease after conization. We performed univariate analysis to compare clinicopathological characteristics between the pre-LACC period (January 2010-March 2018) and post-LACC period (April 2018-December 2021). Survival analysis was performed using a log-rank test to compare 2-years recurrence-free survival during the pre- and post-LACC period.
Results Among 451 patients meeting inclusion criteria, 342 (75,8%) underwent surgery during the pre-LACC period and 109 (24,2%) during the post-LACC period. The rate of the robotic-assisted approach decreased from 60,8% to 23,8% from the pre- to the post-LACC period, while the open approach increased from 39,2% to 76,1% (p < 0.001). Recurrence was observed in 36 patients (8%) within the first 2 years following surgery. No recurrences were observed in patients treated with robotic-assisted surgery during the post-LACC period. No difference in 2-year recurrence-free survival was observed between the pre-and post-LACC period (p=0,45).
Conclusion/Implications The LACC trial led to a significant change in the surgical approach to cervical cancer. The decreased use of robotic surgery did not have an impact on the 2-year recurrence-free survival in our population.
