Evaluation of Surgical Outcomes of Abdominal Radical Hysterectomy and Total Laparoscopic Radical Hysterectomy for Cervical Cancer: A Retrospective Analysis of Data Collected before the LACC Trial

Basilio Pecorino, Maria Gabriella D’Agate, Giuseppe Scibilia, Paolo Scollo, Andrea Giannini, Mariano Catello Di Donna, Vito Chiantera and Antonio Simone Laganà ()
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Basilio Pecorino: Maternal and Child Department, Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna “Kore”, 95126 Catania, Italy
Maria Gabriella D’Agate: Maternal and Child Department, Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna “Kore”, 95126 Catania, Italy
Giuseppe Scibilia: Obstetrics and Gynecology, “Giovanni Paolo II” Hospital, 97100 Ragusa, Italy
Paolo Scollo: Maternal and Child Department, Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna “Kore”, 95126 Catania, Italy
Andrea Giannini: Department of Medical and Surgical Sciences and Translational Medicine, PhD Course in “Translational Medicine and Oncology”, Sapienza University, 00185 Rome, Italy
Mariano Catello Di Donna: Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy
Vito Chiantera: Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy
Antonio Simone Laganà: Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy

IJERPH, 2022, vol. 19, issue 20, 1-9

Abstract: Although a surgical approach is one of the key treatments for stages IA1-IIA2, results of the Laparoscopic Approach to Cervical Cancer (LACC) published in 2018 radically changed the field, since minimally invasive surgery was associated with a four-fold higher rate of recurrence and a six-fold higher rate of all-cause death compared to an open approach. We aimed to evaluate surgical outcomes of abdominal radical hysterectomy (ARH) and total laparoscopic radical hysterectomy (TLRH) for cervical cancer, including data collected before the LACC trial. In our retrospective analysis, operative time was significantly longer in TLRH compared to ARH ( p < 0.0001), although this disadvantage could be considered balanced by lower intra-operative estimated blood loss in TLRH compared with ARH ( p < 0.0001). In addition, we did not find significant differences for intra-operative ( p = 0.0874) and post-operative complication rates ( p = 0.0727) between ARH and TLRH. This was not likely to be influenced by age and Body Mass Index, since they were comparable in the two groups ( p = 0.0798 and p = 0.4825, respectively). Finally, mean number of pelvic lymph nodes retrieved ( p = 0.153) and nodal metastases ( p = 0.774), as well as death rate ( p = 0.5514) and recurrence rate ( p = 0.1582) were comparable between the two groups. Future studies should be aimed at assessing whether different histology/grades of cervical cancer, as well as particular subpopulations, may have significantly different outcomes using minimally invasive surgery or laparotomy, with or without neoadjuvant chemotherapy.

Keywords: cervical cancer; abdominal radical hysterectomy; total laparoscopic radical hysterectomy; minimally invasive surgery; surgical outcomes (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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Citations: View citations in EconPapers (2)

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