EP333\u2005Laparoscopic radical hysterectomy compared to laparotomy in patients with early-stage cervical cancer

Abstract

Introduction/Background The purpose of the study is to compare the two operative techniques in cervical cancer and to determine whether laparoscopy is a safe and effective alternative to conventional abdominal radical hysterectomy (RAH). Methodology Fifty-one cases of radical laparoscopic hysterectomy (RLH) and 41 cases of RAH performed in Medical University in Gdansk (Poland) between 2013–2019 were compared and analyzed in a retrospective observational study. Since the publication of prospective LACC trial in 2018 reporting incomparably worse outcomes of minimally invasive techniques in cervical cancer, laparotomy or modified procedure of vaginally assisted laparoscopic radical hysterectomy (VALRH) without uterine manipulator, was carried out in all patients. We included patients with early-stage cervical cancer only: IA1–IB1 according to FIGO 2014 staging. Results There were no differences in preoperative clinical FIGO stage in both groups, with the most common Ib1 in 93% and 86% of patients respectively in RAH and RLH group. Although squamous cell cancer was the most frequent, we found a high percentage of adenocarcinoma in RLH (25%) compared to RAH (7%), which can affect the long-term outcomes. We have shown a significantly less blood loss in the minimally invasive technique (p<0.001), a lower rate of postoperative complications (p=0.003) and slightly but statistically significant shorter hospital stay (p=0.04). RLH required longer operational time (p<0.001) and was associated with a smaller number of lymph nodes removed (p<0.001), with the same rate of intraoperative complication rate (p>0.05). There were no differences in recurrences in both groups (5.8% for RLH and 5% for RAH). Conclusion As in oncology of the 21st century, we are more and more interested in patients quality of life, we have to focus on the development of minimally invasive techniques. Radical laparoscopic hysterectomy still can be a safe and effective alternative to laparotomy in early-stage cervical cancer. Disclosure Nothing to disclose.