Article Text
Abstract
Introduction It remains unclear whether modifying laparoscopic radical hysterectomy (LRH) to adopt tumour-free principles can improve oncologic outcomes in patients with early-stage cervical cancer (ESCC).
Methods We performed a retrospective cohort study of 276 patients with ESCC treated between January 2017 and January 2023, including 151 who underwent LRH incorporating MTF techniques and 125 who underwent conventional LRH with a uterine manipulator and unprotected intracorporeal colpotomy. Oncologic outcomes and perioperative results were analyzed using multivariate analysis and inverse probability treatment weighting (IPTW).
Results The MTF group had a shorter length of hospital stay (6 vs. 7 days) than the non-MTF group. However, there were no significant differences in operative time, haemoglobin decrease and complications. After a median follow-up of 36.0 (range: 15.3–62.0) months for the MTF group and 66.8 (range: 3.0–82.5) months for the non-MTF group, recurrence was observed in 2 (1.3%) and 16 (12.8%) of the patients, respectively. The 2-, and 3-year DFS rate in the MTF group was 99.3%, and 98.0%, while the 2-, 3-, and 4.5-year DFS rates in the non-MTF group were 91.9%, 89.5%, and 87.8%, respectively. Adjusted multivariate analysis showed that MTF was an independent predictor of longer DFS (HR: 0.136, p=0.010). After IPTW, patients in the MTF group had more favorable DFS than those in the non-MTF group (log-rank p=0.001).
Conclusion/Implications LRH incorporating MTF techniques is a feasible treatment for patients with ESCC. Oncologic outcomes of individuals who underwent this procedure were similar to those of open approach, which was more favorable than those of conventional LRH.