Comparison of laparoscopic and abdominal radical hysterectomy for patients with FIGO stage IB1 cervical cancer

Chang, Suk Joon; Kim, Woo Young; Chang, Ki Hong; Ryu, Hee Sug

Abstract

OBJECTIVE
The purpose of this study was to compare the safety, morbidity, and recurrence rate of laparoscopic radical hysterectomy (LRH) with lymphadenectomy and abdominal radical hysterectomy with lymphadenectomy (ARH) for IB1 cervical cancer.
METHODS
We conducted retrospective analysis of 91 consecutive patients with FIGO stage IB1 cervical cancer who underwent laparoscopic or abdominal radical hysterectomy with pelvic and/or para-aortic lymphadenectomy between 2006 and 2009.
RESULTS
Thirty-two patients undergoing LRH and 59 patients undergoing ARH. There was no difference in demographic data between the two groups. Mean estimated blood loss was 567.9 mL with ARH group compared with 429 mL with LRH group (p=0.001). Mean operating time was 242.0 minutes for ARH group compared with 249.5 minutes for LRH group (p=0.597). Return of bowel motility was observed earlier after LRH (p=0.013). A mean 22.8 pelvic lymph nodes were obtained during ARH compared with 21.6 during LRH (p=0.573). The median duration of hospital stay was significantly shorter for LRH (p=0.016) group. No statistically significant difference was found between the two groups when the recurrence rate was compared. Progression-free survival rates were 94.9% in ARH group and 94.4% in LRH group respectively (p=0.9317). With a median follow up of 17.9 months, all the patients are alive with no disease-related deaths.
CONCLUSION
LRH is a safe and effective therapeutic procedure for management of Ib1 cervical cancer with reducing blood loss, postoperative morbidity, and postoperative hospital stay and oncologic results of this procedure are comparable to ARH with the limitation of a short follow-up period. Further randomized studies are necessary to evaluate long-term clinical outcome.