Laparoscopic Radical Hysterectomy in Early Cervical Cancer: Is There a Future?

Since the time minimally invasive surgery (MIS) has been introduced into the field of oncology, it has taken over open surgery in almost all systems except few. Cervical carcinoma is one such malignancy where laparoscopy is struggling to find its place. Though initial studies were encouraging, the prospective studies, including LACC trial, were not in favor of MIS.

The aim is to retrospectively analyze the outcomes in terms of oncological clearance and survival in patients with early cervical cancer treated with open (ORH) or laparoscopic radical hysterectomy (LRH).

The records of patients treated with ORH or LRH from 2013 to 2020 in our institute were analyzed. The parameters collected were demographic data, preoperative stage, grade, histopathological reports, and number of lymph nodes harvested. The overall survival and disease-free survival (OS, DFS) are calculated.

A total of 50 LRH and 36 ORH were performed between 2013 and 2020. Margins were free in all cases in both groups. There was no significant deference in histopathological parameters. The 3-year OS was 93.48% and 97.06% in LRH and ORH (P = 0.3). The same for < 2 cm tumors were 100% and 95.25% (P = 0.7). The DFS at the end of 2 and 5 years was 96% and 85% for LRH while that of ORH group were 94.44% and 84.92% (P = 0.9).

There was no significant difference in histopathological parameters, OS or DFS between lap and open radical hysterectomies. Large randomized controlled studies that have overcome the shortcomings of LACC trial are needed to confirm the findings.