Laparoscopic radical hysterectomy is associated with worse disease-free survival (DFS) than open radical hysterectomy for stage IB1 (FIGO 2009) cervical cancer patients with tumour size ≤2 cm, suggests a study published in the International Journal of Gynecological Cancer.
The study retrospectively reviewed medical records for patients who underwent either laparoscopic or open radical hysterectomy from January 2010 to December 2018.
Of 325 cervical cancer patients included, 129 underwent laparoscopic surgery and 196 patients had open surgery.
Median follow-up was 51.8 months for laparoscopic and 49.5 months for open surgery. Patients in the laparoscopic group had significantly worse five-year DFS than those in the open group (90.4% vs 97.7%; adjusted hazard ratio [HR] 4.64; 95% CI 1.26-17.06; P=.02). There was no significant difference in five-year overall survival (96.9% vs 99.4%; P=.33).
In patients with non-squamous cell carcinoma or with grade II-III cancer, laparoscopic surgery had significantly worse five-year DFS compared with open surgery (74% vs 100%; P=.01, and 88.8% vs 98.0%; P=.02, respectively).
The authors say further studies may shed additional light on the impact of minimally-invasive surgery in this low-risk patient population.