Laparoscopic versus open radical hysterectomy in patients with stage IB2 and IIA2 cervical cancer.

OBJECTIVES

To compare survival and surgical outcomes of laparoscopic (LRH) and open radical hysterectomy (ORH) in patients with stage IB2 and IIA2 cervical cancer.

METHODS

A retrospective analysis was performed on 303 patients with stage IB2 and IIA2 cervical cancer who underwent LRH (n = 115) or ORH (n = 188).

RESULTS

Two patients (1.7%) in the LRH group required conversion to laparotomy. There was no difference with respect to operating time, perioperative change in hemoglobin level, and need for transfusion. However, in the LRH group, estimated blood loss (P = 0.003) was significantly lower, time to recovery of bowel movement (P < 0.001) and length of postoperative hospital stay (P < 0.001) were significantly shorter, and postoperative complications were significantly less frequent (P = 0.036). The 5-year disease-free survival was 78% in the LRH group and 77% in the ORH group (P = 0.718), and 5-year overall survival was 83% in both groups (P = 0.746). There were no differences in pattern of recurrence (P = 0.225) and median time to recurrence (12 vs. 13 months; P = 0.240).

CONCLUSIONS

LRH has similar therapeutic efficacy to ORH in patients with bulky early-stage cervical cancer. However, LRH has more favorable surgical outcomes. Therefore, LRH is not only a reasonable alternative to ORH but also the preferred surgical procedure for these patients.