The Role of Laparoscopic Radical Hysterectomy in Early-Stage Adenocarcinoma of the Uterine Cervix.

OBJECTIVE

To compare long-term survival outcomes and patterns of recurrence of laparoscopic radical hysterectomy (LRH) and open radical hysterectomy (ORH) in early-stage cervical adenocarcinoma.

METHODS

The medical records of 293 patients with stage IA2-IIA cervical adenocarcinomas who underwent radical hysterectomy were retrospectively reviewed.

RESULTS

In total, 186 patients underwent LRH and 107 underwent ORH. There was no difference between the two surgery groups in clinicopathologic characteristics. There were no differences in disease-free survival (DFS) and overall survival (OS) between the LRH and ORH groups (88.7 vs. 84.1 %, P = 0.725; and 93.0 vs. 86.9 %, P = 0.735) for univariate analysis and multivariate analysis after adjusting for other significant prognostic factors. There was no difference in the patterns of recurrence between the two surgery groups (P = 0.220). The median time interval between surgery and the first recurrence were 25 months (range, 3-100 months) for LRH group and 14 months (range, 3-128 months) for ORH group (P = 0.230). The LRH group showed significantly fewer postoperative complications (P < 0.001), less estimated blood loss (P < 0.001), faster bowel movement recovery (P < 0.001), shorter postoperative hospital stay (P < 0.001), and a lower rate of wound dehiscence, ileus, lymphedema, infected lymphocele, and pelvic abscess (P = 0.004, 0.011, 0.017, and 0.040, respectively).

CONCLUSIONS

LRH has comparable survival outcomes with ORH and did not affect the pattern of recurrence in early-stage adenocarcinoma of the uterine cervix. The surgical outcomes were more favorable than ORH.