Comparison of abdominal and minimally invasive radical hysterectomy in patients with early stage cervical cancer

Sang Il Kim¹, Jiwoo Lee¹, Jiyun Hong¹, Sung Jong Lee², Dong Choon Park¹, Joo Hee Yoon^1✉

1. Department of Obstetrics and Gynecology, St. Vincent's hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
2. Department of Obstetrics and Gynecology, Seoul St. Mary's hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.

Citation:
Kim SI, Lee J, Hong J, Lee SJ, Park DC, Yoon JH. Comparison of abdominal and minimally invasive radical hysterectomy in patients with early stage cervical cancer. Int J Med Sci 2021; 18(5):1312-1317. doi:10.7150/ijms.55017. Available from https://www.medsci.org/v18p1312.htm

Abstract

Purpose: The aim of this study was to compare survival outcomes of open radical hysterectomy and minimally invasive radical hysterectomy (MIS) in early stage cervical cancer.

Methods: A retrospective analysis of 148 patients with stage IB1 - IIA2 cervical cancer who underwent either minimally invasive or open radical hysterectomy. Tumor characteristics, recurrence rate, disease-free survival (DFS), and overall survival (OS) were compared according to surgical approach.

Results: In total, 110 and 38 patients were assigned to open surgery and MIS groups. After a medical follow-up of 42.1 months, the groups showed similar survival outcomes (recurrence rate, DFS, and OS). However, in patients with tumor size >2 cm, recurrence rate was significantly higher in MIS group (22.5% vs 0%; p=0.008). And in patients with tumor size >2 cm, MIS group showed significantly poorer DFS than open surgery group (p=0.017), although OS was similar between the two groups (p=0.252).

Conclusion: In patients with tumor size >2 cm, MIS was associated with higher recurrence rates and poorer DFS than open surgery. However, in patients with tumor size ≤2 cm, MIS did not seem to compromise oncologic outcomes.

Keywords: cervical cancer, minimally invasive surgery, laparoscopic surgery, radical hysterectomy, LACC trial