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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

Author

Listed:
  • 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
    Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, 90133 Palermo, Italy)

  • Vito Chiantera

    (Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy
    Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy)

  • Antonio Simone Laganà

    (Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, 90127 Palermo, Italy
    Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy)

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.

Suggested Citation

  • Basilio Pecorino & Maria Gabriella D’Agate & Giuseppe Scibilia & Paolo Scollo & Andrea Giannini & Mariano Catello Di Donna & Vito Chiantera & Antonio Simone Laganà, 2022. "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," IJERPH, MDPI, vol. 19(20), pages 1-9, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:20:p:13176-:d:940983
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    References listed on IDEAS

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    1. Ottavia D’Oria & Giacomo Corrado & Antonio Simone Laganà & Vito Chiantera & Enrico Vizza & Andrea Giannini, 2022. "New Advances in Cervical Cancer: From Bench to Bedside," IJERPH, MDPI, vol. 19(12), pages 1-5, June.
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    Cited by:

    1. Graziella Moufawad & Antonio Simone Laganà & Nassir Habib & Vito Chiantera & Andrea Giannini & Federico Ferrari & Amerigo Vitagliano & Luigi Della Corte & Giuseppe Bifulco & Zaki Sleiman, 2023. "Learning Laparoscopic Radical Hysterectomy: Are We Facing an Emerging Situation?," IJERPH, MDPI, vol. 20(3), pages 1-10, January.
    2. Benito Chiofalo & Antonio Simone Laganà & Fabio Ghezzi & Camilla Certelli & Jvan Casarin & Valentina Bruno & Isabella Sperduti & Vito Chiantera & Panagiotis Peitsidis & Enrico Vizza, 2023. "Beyond Sentinel Lymph Node: Outcomes of Indocyanine Green-Guided Pelvic Lymphadenectomy in Endometrial and Cervical Cancer," IJERPH, MDPI, vol. 20(4), pages 1-11, February.

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