STUDY OBJECTIVE: To compare perioperative and long-term outcomes related to laparoscopic and open abdominal surgical management of cervical cancer. DESIGN: Propensity-matched comparison of prospectively collected data (Canadian Task Force classification II-1). SETTING: University teaching hospital. PATIENTS: Sixty-five propensity-matched patient pairs (130 patients) undergoing either laparoscopy or open abdominal surgical procedures to treat cervical cancer. INTERVENTION: Radical hysterectomy plus lymphadenectomy was performed via the laparoscopic (LRH) or open abdominal approach (RAH). MEASUREMENT AND MAIN RESULTS: Baseline characteristics of the study populations were similar. In the LRH group the procedure was converted to open surgery in 2 patients (2%). Compared with the RAH group, patients undergoing LRH experienced less blood loss (200 vs 500 mL; p < .001), a lower transfusion rate (6% vs 22%; p = .02), similar operative time (245 vs 259.5 minutes; p = .26), and shorter length of hospital stay (4 vs 8 days; p < .001). No between-group differences in intraoperative complications were recorded (p = 1.0); however, a trend toward a lower postoperative complication rate (Accordion system grade ≥ 3) was observed for LRH compared with RAH (4 patients [6%]) vs 12 patients [18%]; p = .06). Five-year disease-free survival (p = .6, log-rank test) and overall survival (p = .31, log-rank test) did not differ statistically between women undergoing LRH or RAH. CONCLUSION: Laparoscopy ensures the same results as open surgery insofar as radicality and long-term survival. Use of the laparoscopic approach is associated with improved short-term results, minimizing the occurrence of severe postoperative complications.
STUDY OBJECTIVE: To compare perioperative and long-term outcomes related to laparoscopic and open abdominal surgical management of cervical cancer. DESIGN: Propensity-matched comparison of prospectively collected data (Canadian Task Force classification II-1). SETTING: University teaching hospital. PATIENTS: Sixty-five propensity-matched patient pairs (130 patients) undergoing either laparoscopy or open abdominal surgical procedures to treat cervical cancer. INTERVENTION: Radical hysterectomy plus lymphadenectomy was performed via the laparoscopic (LRH) or open abdominal approach (RAH). MEASUREMENT AND MAIN RESULTS: Baseline characteristics of the study populations were similar. In the LRH group the procedure was converted to open surgery in 2 patients (2%). Compared with the RAH group, patients undergoing LRH experienced less blood loss (200 vs 500 mL; p < .001), a lower transfusion rate (6% vs 22%; p = .02), similar operative time (245 vs 259.5 minutes; p = .26), and shorter length of hospital stay (4 vs 8 days; p < .001). No between-group differences in intraoperative complications were recorded (p = 1.0); however, a trend toward a lower postoperative complication rate (Accordion system grade ≥ 3) was observed for LRH compared with RAH (4 patients [6%]) vs 12 patients [18%]; p = .06). Five-year disease-free survival (p = .6, log-rank test) and overall survival (p = .31, log-rank test) did not differ statistically between women undergoing LRH or RAH. CONCLUSION: Laparoscopy ensures the same results as open surgery insofar as radicality and long-term survival. Use of the laparoscopic approach is associated with improved short-term results, minimizing the occurrence of severe postoperative complications.
Authors: Roni Nitecki; Pedro T Ramirez; Michael Frumovitz; Kate J Krause; Ana I Tergas; Jason D Wright; J Alejandro Rauh-Hain; Alexander Melamed Journal: JAMA Oncol Date: 2020-07-01 Impact factor: 31.777
Authors: Lu Wu; Diamantis I Tsilimigras; Katiuscha Merath; J Madison Hyer; Anghela Z Paredes; Rittal Mehta; Kota Sahara; Fabio Bagante; Eliza W Beal; Feng Shen; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2019-04-22 Impact factor: 3.452
Authors: Alexander Melamed; Daniel J Margul; Ling Chen; Nancy L Keating; Marcela G Del Carmen; Junhua Yang; Brandon-Luke L Seagle; Amy Alexander; Emma L Barber; Laurel W Rice; Jason D Wright; Masha Kocherginsky; Shohreh Shahabi; J Alejandro Rauh-Hain Journal: N Engl J Med Date: 2018-10-31 Impact factor: 91.245