AUTHOR=Qin Meng , Siyi Li , Huang Hui-Fang , Li Yan , Gu Yu , Wang Wei , Shan Ying , Yin Jie , Wang Yong-Xue , Cai Yan , Chen Jia-Yu , Jin Ying , Pan Ling-Ya 

TITLE=A Comparison of Laparoscopies and Laparotomies for Radical Hysterectomy in Stage IA1-IB1 Cervical Cancer Patients: A Single Team With 18 Years of Experience

JOURNAL=Frontiers in Oncology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.01738

DOI=10.3389/fonc.2020.01738

ISSN=2234-943X

ABSTRACT=<sec><title>Objective</title><p>To investigate the safety and efficacy of abdominal radical hysterectomy (ARH) and laparoscopic radical hysterectomy (LRH) in managing early-stage cervical cancer.</p></sec><sec><title>Methods</title><p>This retrospective study comprised patients with FIGO stage IA1 with lymphovascular space invasion (LVSI), IA2, and IB1 cervical cancer who underwent radical hysterectomy performed by a single gynecologic oncology team at Peking Union Medical College Hospital from 2000–2018. The clinicopathological characteristics, surgical outcomes, and survival outcomes were compared between the two groups.</p></sec><sec><title>Results</title><p>The ARH and LRH groups consisted of 84 and 172 patients, respectively. The 5-year progression-free survival (PFS) rates were 89.3 and 95.9% in the ARH and LRH groups (<italic>P</italic> = 0.122, adjusted HR = 0.449, 95% CI: 0.162–1.239), respectively, while the 5-year overall survival (OS) rates were 95.2 and 98.8%, respectively (<italic>P</italic> = 0.578, adjusted HR = 0.650, 95% CI: 0.143–2.961). The presence of more than two comorbidities led to poor OS (<italic>P</italic> = 0.011). For patients with a BMI greater than 24 kg/m<sup>2</sup>, LRH was associated with better PFS (<italic>P</italic> = 0.039). Compared with ARH, LRH was associated with a shorter operation time (248.8 vs. 176.9 min, <italic>P</italic> &lt; 0.001), less blood loss (670.2 vs. 200.9 ml, <italic>P</italic> &lt; 0.001), and lower postoperative ileus rates (2.4% vs. 0%, <italic>P</italic> = 0.042). No significant differences were observed in PFS and OS between 2006–2012, 2013–2015, and 2016–2018 in the LRH group (<italic>P</italic> = 0.126 and <italic>P</italic> = 0.583).</p></sec><sec><title>Conclusion</title><p>Compared with ARH, LRH yields similar survival and improved surgical outcomes in patients with early-stage cervical cancer. LRH is not inferior to ARH for select cervical cancer patients treated by a single team with adequate laparoscopy experience.</p></sec>