J Gynecol Oncol.  2021 Mar;32(2):e17. 10.3802/jgo.2021.32.e17.

Comparison between laparoscopic and abdominal radical hysterectomy for stage IB1 and tumor size <2 cm cervical cancer with visible or invisible tumors: a multicentre retrospective study

Affiliations
  • 1Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • 2Department of Obstetrics and Gynecology, Yuncheng Central Hospital, Yuncheng, China
  • 3Department of Obstetrics and Gynecology, Guizhou people's Hospital, Guiyang, China
  • 4Department of Obstetrics and Gynecology, Daping Hospital, Army Medical University, Chongqing, China
  • 5Department of Gynecology, Shenzhen Maternal and Child Health Hospital, Shenzhen, China
  • 6Department of Obstetrics and Gynecology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
  • 7Department of Obstetrics and Gynecology, Pan Yu Central Hospital, Guangzhou, China
  • 8Department of Epidemiology, College of Public Health, Guangzhou Medical University, Guangzhou, China
  • 9Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China

Abstract


Objective
To compare 5-year disease-free survival (DFS) and overall survival (OS) rates of laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for stage IB1 and tumor size <2 cm with visible or invisible tumors.
Methods
We retrospectively compared the oncological outcomes of 1,484 cervical cancer patients with IB1 and tumor size <2 cm on final pathology, who received ARH (n=899) or LRH (n=585) between January 2004 and December 2016. Patients were divided into visible tumor subgroup (ARH: n=668, LRH: n=444) and invisible tumor subgroup (ARH: n=231, LRH: n=141) according to tumor type.
Results
LRH and ARH showed similar 5-year DFS and OS rates (93.3% vs. 93.1%, p=0.997; 96.2% vs. 97.5%, p=0.351) in total study population. LRH was not associated with worse 5-year DFS rate (hazard ratio [HR]=0.96; 95% confidence interval [CI]=0.58–1.58; p=0.871) or OS rate (HR=1.37; 95% CI=0.65–2.89; p=0.409) by multivariable analysis. In the visible tumor subgroups, LRH and ARH showed similar 5-year DFS and OS rates (91.9% vs. 91.9%, p=0.933; 95.0% vs. 96.9%, p=0.276), and LRH was not associated with worse 5-year DFS or OS rate (p=0.804, p=0.324). In the invisible tumor subgroups, LRH and ARH also showed similar 5-year DFS and OS rates (97.3% vs. 97.1%, p=0.815; 100% vs. 99.5%, p=0.449), and LRH was not associated with worse 5-year DFS rate (p=0.723).
Conclusions
Among patients with stage IB1 and tumor size <2 cm, whether the tumor is visible or not, the oncological outcomes of LRH and ARH among cervical cancer patients are comparable. This suggests that LRH may be suitable for stage IB1 and tumor size <2 cm with visible or invisible tumors.

Keyword

Cervical Cancer; Laparoscopy; Laparotomy; Hysterectomy; Disease-Free Survival
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