loading page

Comparison of cervical cancer outcomes following open and laparoscopic surgery performed by experienced surgeons: a retrospective study
  • +9
  • Chunlin Chen,
  • Jianxin Guo,
  • Jun Lan,
  • Pengfei Li,
  • Xiaonong Bin,
  • Jinghe Lang,
  • Wuliang Wang,
  • Anwei Lu,
  • Min Hao,
  • Weili Li,
  • Hui Duan,
  • Ping Liu
Chunlin Chen
Author Profile
Jianxin Guo
Daping hospital, Army Medical University
Author Profile
Jun Lan
Nanfang Hospital, Southern Medical University
Author Profile
Pengfei Li
Southern Medical University Nanfang Hospital
Author Profile
Xiaonong Bin
College of Public Health,Guangzhou Medical University
Author Profile
Jinghe Lang
Peking Union Medical College Hospital
Author Profile
Wuliang Wang
The Second Affiliated Hospital of Zhengzhou University
Author Profile
Anwei Lu
The Maternity and Child Care Hospital of Guizhou Province
Author Profile
Min Hao
The Second Hospital of Shanxi Medical University
Author Profile
Weili Li
Nanfang Hospital, Southern Medical University
Author Profile
Hui Duan
Nanfang Hospital, Southern Medical University
Author Profile
Ping Liu
Nanfang Hospital, Southern Medical University
Author Profile

Abstract

Objective: Compare the outcomes associated with laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for cervical cancer. Design: Retrospective, multicenter observational analysis Setting: Select patients of LRH and ARH from cervical cancer database and compare their outcomes. Population: Patients with stage IA1 (Lymphovascular space invasion [LVSI]-positive) and stage IIA2 cervical cancer (N=6804) were enrolled, of whom 3003 underwent laparoscopy (LRH group), and 3801 underwent laparotomy (ARH group). Methods: Kaplan-Meier survival analysis,propensity score matching (PSM) and Cox regression. Main Outcome Measures: Five-year overall survival (OS) and 5-year disease-free survival (DFS) Results: Before PSM, there was no difference in outcomes between the groups (5-year OS: LRH 89.2% vs. ARH 90.6%, P=0.903.; 5-year DFS: LRH 84.5% vs. ARH 87.1%, P=0.155). Surgical approach did not affect 5-year OS; however, it did affect 5-year DFS (hazard ratio [HR]=0.827, 95% confidence interval [CI]: 0.711-0.962, P=0.014). After PSM, there was no difference in 5-year OS between the LRH (N=1828) and ARH (N=1828) groups (91.0% vs. 93.1%, P=0.220); but there was a significant difference in 5-year DFS between the LRG and ARH groups (86.2% vs. 90.6%, P=0.002). Cox regression revealed that the surgical approach did not affect 5-year OS; however, it did affect 5-year DFS (HR=0.701, 95% CI: 0.563-0.874, P=0.002). Conclusions: For IA1 (LVSI-positive) and IIA1 cervical cancers, the recurrence rate following laparoscopic surgery was higher than that following open surgery, regardless of the surgeon’s experience.