Retrospective comparison of laparoscopic versus open radical hysterectomy after neoadjuvant chemotherapy for locally advanced cervical cancer

ObjectiveTo compare outcomes after laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for locally advanced cervical cancer (LACC)after neoadjuvant chemotherapy (NACT).MethodsIn a retrospective study, data were analyzed from patients with FIGO stage IB2–IIB cervical cancer who underwent LRH or ARH after NACT at Union Hospital, Wuhan, China, between January 2007 and August 2013.Perioperative outcomes and survival were compared.ResultsOverall, 99 patients who underwent LRH and 30 who underwent ARH were included. Compared with ARH patients, LRH patients presented with lower-stage tumors (P = 0.013). Median operative time, number of harvested lymph nodes, and rate of positive surgical margins did not differ significantly between the groups, but LRH resulted in less blood loss (median 300 mL [range 20–1100] vs 375 mL [100–1200]; P = 0.027). There were two intraoperative complications and 23 postoperative complications in the LRH group, and 12 postoperative complications in the ARH group. No conversions occurred in the LRH group; all complications were managed without severe sequelae. As of March 2014, recurrence had been noted for 6(6.1%) LRH patients and 2 (6.7%) ARH patients.ConclusionLRH was similar to ARH in terms of safety, feasibility, and morbidity, with less blood loss among women with LACC undergoing NACT. Long-term outcomes need to be documented.