Comparison of Different Surgical Approaches for Stage IB1 Cervical Cancer Patients: A Multi-institution Study and a Review of the Literature

Giacomo Corrado, Enrico Vizza, Francesco Legge, Luigi Pedone Anchora, Isabella Sperduti, Anna Fagotti, Emanuela Mancini, Valerio Gallotta, Ashanti Zampa, Benito Chiofalo, Giovanni Scambia

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective The aim of this retrospective study was to assess the surgical and oncological outcome of 3 different surgical approaches (laparotomy, laparoscopy, and robotic surgery) in the treatment of early-stage cervical cancer International Federation of Gynecology and Obstetrics (FIGO) stage IB1. Methods All patients with a histologically confirmed diagnosis of early-stage cervical cancer, FIGO stage IB1, who underwent abdominal radical hysterectomy (ARH), laparoscopic radical hysterectomy, or robotic radical hysterectomy with or without pelvic and aortic lymphadenectomy were included in the study. A review of the literature was conducted. Results Three hundred forty-one patients, between January 2001 and December 2016, were included in this study: 101 patients were submitted to ARH, 152 to laparoscopic radical hysterectomy, and 88 to robotic radical hysterectomy. In 97% and 11.5% of cases, bilateral pelvic and aortic lymph node dissections were performed, respectively. The 3 groups were similar in regard to clinical characteristics. Compared with ARH, the minimally invasive surgery group was safer in terms of estimated blood loss, transfusion rates, and hospital stay. Above all, robotic surgery was equivalent to laparoscopy in terms of intraoperative and postoperative complications, hospital stay, conversions, and reintervention. On the other hand, robotic surgery had better outcomes compared with laparoscopy in terms of transfusion rates and was equivalent to abdominal surgery and laparoscopy in regard to oncological outcomes. Conclusions Our study confirmed that minimally invasive surgery (laparoscopy or robotics) was as adequate and effective as abdominal surgery in terms of surgical and oncological outcomes in the surgical treatment of EEC FIGO stage IB1.

Original languageEnglish
Pages (from-to)1020-1028
Number of pages9
JournalInternational Journal of Gynecological Cancer
Volume28
Issue number5
DOIs
Publication statusPublished - Jun 1 2018

Keywords

  • Abdominal radical hysterectomy
  • Early-stage cervical cancer
  • Minimally invasive radical hysterectomy

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

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