Is laparotomy better than laparoscopic surgery in early cervical cancer?

Abstract

Introduction: Cervical cancer is the fourth most common cancer among women worldwide. Conventional open cervical cancer surgery was often performed in the past, but laparoscopic/robot-assisted surgery is now more common, in accordance with the recent trend toward increased use of minimally invasive surgery. Materials and methods: A total of 266 patients with early cervical cancer, who underwent type II, III radical hysterectomy with or without pelvic lymphadenectomy during the 10-year period between March 2008 and February 2018 at a tertiary hospital (performed by three surgeons), were divided into laparotomy (group 1, n = 132) and laparoscopic/robot-assisted surgery (group 2, n = 134) groups. The variables of interest in this retrospective chart review study were age, body mass index (BMI), cancer stage, surgery type (laparotomy or laparoscopic/robot-assisted), pathology, complications after surgery, additional therapy after surgery, recurrence, and mortality. Results: The surgery type differed significantly according to cancer stage: patients in early and later stages were more likely to undergo laparotomy and laparoscopic/robot-assisted surgery, respectively (p = 0.016). Patients with a higher BMI were more likely to undergo laparoscopic/robot-assisted surgery (p = 0.032). Most patients (n = 170) received adjuvant therapy following surgery. The cervical cancer recurrence rate was 8.3% (11/132) group 1 and 8.2% (11/134) group 2 (p = 0.573). The proportion of postsurgical complications was similar, 8% in group 1 and 5% in group 2, p = 0.469. Conclusions: In this heterogeneous group of patients, most of whom received adjuvant therapy, with found no difference by univariate analysis in the mortality or recurrence rate or the rate of postoperative complications.