Article Text
Abstract
Introduction This study evaluates the influence of different surgical approaches in determining survival probabilities and adjuvant treatment in patients with early stage cervical cancer in Chile. We compare safety, surgical outcomes and overall survival between laparoscopic radical hysterectomy (LHR) and open radical hysterectomy (OHR)
Methods Prospective cohort of all women that were candidate for radical hysterectomy in our institution between 2013 to 2018. We conducted analysis using Kaplan-Meier and chi-squared test.
Results We analyzed 101 patients, 51 ORH and 50 LRH. Both groups were similar regarding age, co-morbidities, histology and clinical stage Five years survival was 93.1% (CI 88,2 – 98,2%), no statistical differences between both groups was found, 39% of patients received adjuvant treatment, there were no significant association with the type of surgery (p = 0.6444). Significant associations were found between tumor size and adjuvant treatment (p = 0.01521), with larger tumors more likely to receive additional therapy. Permeations were also significantly associated with the likelihood of receiving adjuvant therapy, underscoring their importance in treatment planning. Patients undergoing conization might exhibit improved survival outcomes. There were no statistical differences between body mass index, pelvic lymph nodes removed and operative time. Estimated lost blood was decreased (p=0.001) and hospital stay (p=0.001) was significantly shorter in the LHR.
Conclusion/Implications Laparascopic radical surgery has similar therapeutic efficacy and overall survival compare to open surgery, however it has more favorable surgical outcomes. The type of surgery did not directly influence the decision for adjuvant treatment, clinical features such as tumor size and surgical outcomes were pivotal