Retrospective Comparison of Laparoscopic versus Open Radical Hysterectomy for Early-Stage Cervical Cancer in a Single Tertiary Care Institution from Lithuania between 2009 and 2019

Medicina (Kaunas). 2022 Apr 17;58(4):553. doi: 10.3390/medicina58040553.

Abstract

Background and Objectives: A great debate within the academic arena was evoked by the LACC study, giving rise to doubt regarding the oncological outcomes of the laparoscopic approach for early-stage cervical cancer. This encouraged us to conduct a retrospective analysis of CC treatment surgical approaches applied to the patients at tertiary level Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania, between 2009 and 2019. Materials and Methods: The retrospective study was carried out to evaluate the outcomes after 28 laparoscopic and 62 laparotomic radical hysterectomies for early cervical cancer in a single tertiary care institution performed during the period 2009-2019. For statistical analysis of patients' parameters, SPSS v. 17.0 was applied, together with the Kaplan-Meier method with a long-rank test and the Cox proportional hazard regression model used for bi-variate analysis determining OS outcomes between MIS and open-surgery groups. Results: After computing data with the Cox regression model, there was no significant difference of the 36-months overall survival between laparoscopy and laparotomy groups, as opposed to the LACC study. Conclusions: Our tertiary institution faces a considerable challenge, and we acknowledge the limitations of the study and also feel a responsibility to follow the latest guidelines. Currently, it appears that the most substantial attention should be focused on the cessation of uterine manipulator use as well as laparoscopic technique learning curves.

Keywords: LACC study; early-stage cervical cancer; radical hysterectomy; surgical gynecological oncology.

MeSH terms

  • Disease-Free Survival
  • Female
  • Humans
  • Hysterectomy / methods
  • Laparoscopy* / methods
  • Lithuania / epidemiology
  • Neoplasm Staging
  • Retrospective Studies
  • Tertiary Healthcare
  • Uterine Cervical Neoplasms* / pathology