Is laparotomy better than laparoscopic surgery in early cervical cancer?

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.

Uterine cervical neoplasms; Laparotomy; Laparoscopy.

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