Laparoscopic versus abdominal radical hysterectomy for stage IB1 cervical cancer patients with tumor size ≤ 2 cm: a case-matched control study.

Abstract

BACKGROUND:

To investigate the survival outcomes of stage IB1 cervical cancer patients with tumor size ≤ 2 cm who underwent laparoscopic or abdominal radical hysterectomy.

METHODS:

We retrospectively analyzed stage IB1 cervical cancer patients with a tumor size ≤ 2 cm who underwent laparoscopic or abdominal radical hysterectomy in China between 2004 and 2016. A real-world study (RWS) and 1:1 matching was used in the study.

RESULTS:

After 1:1 matching, laparoscopic (n = 926) and abdominal radical hysterectomy (n = 926) had similar 5-year overall survival and disease-free survival rates in stage IB1 cervical cancer with a tumor size ≤ 2 cm. Subsequently, in cervical squamous carcinoma with tumor size ≤ 2 cm, the laparoscopic and abdominal groups (724 cases, respectively) showed comparable 5-year overall survival and disease-free survival rates. Finally, in cervical adenocarcinoma or adenosquamous carcinoma with tumor size ≤ 2 cm, the laparoscopic group (n = 174) had a similar 5-year overall survival rate but a lower disease-free survival rate compared to those of the abdominal group (disease-free survival: 89.9% vs. 98.0%, respectively, P = 0.006; hazard ratio (HR), 5.094; 95% confidence interval (CI), 1.400-18.535; P = 0.013; n = 174). The RWS results were similar to the 1:1 matching results.

CONCLUSIONS:

Patients with squamous cell carcinoma in stage IB1 cervical cancer with tumor size ≤ 2 cm might be suitable for laparoscopic surgery, while patients with adenocarcinoma or adenosquamous carcinoma with tumor size ≤ 2 cm are not candidates for laparoscopic surgery.

• Authors: Chunlin Chen, Ping Liu, Yan Ni, Lian Tang, Yan Xu, Xiaonong Bin, Jinghe Lang
• Journal: International journal of clinical oncology (Int J Clin Oncol) Vol. 25 Issue 5 Pg. 937-947 (May 2020) ISSN: 1437-7772 [Electronic] Japan
• PMID: 32062731 (Publication Type: Controlled Clinical Trial, Journal Article, Multicenter Study)

Topics

• Abdomen (surgery)
• Adenocarcinoma (pathology)
• Adult
• Carcinoma, Adenosquamous (mortality, pathology, surgery)
• Carcinoma, Squamous Cell (mortality, pathology, surgery)
• Case-Control Studies
• China
• Disease-Free Survival
• Female
• Humans
• Hysterectomy (methods)
• Laparoscopy (methods)
• Middle Aged
• Retrospective Studies
• Survival Rate
• Uterine Cervical Neoplasms (mortality, pathology, surgery)