Laparoscopic Radical Hysterectomy and Pelvic Lymphadenectomy Can Be Routinely Used for Treatment of Early-stage Cervical Cancer: A Single-institute Experience With 404 Patients

Study Objective The aim of our study was to determine if laparoscopic radical hysterectomy (LRH) can be routinely used for the treatment of early-stage cervical cancer. Design From May 2008, LRH was planned for all primarily operable cervical cancer patients after receiving informed consent in our department. The surgical and oncologic outcomes were retrospectively evaluated (Canadian Task Force classification III). Setting University teaching hospital. Patients and Interventions By August 2013, 404 patients with invasive cervical cancer were deemed operable, and all of them were subjected to upfront LRH, except 1 patient who insisted on open surgery. Measurements and Main Results The planned LRH was abandoned in 3 patients because of inoperability. The median operative time was 240 minutes (range, 100–410 minutes). The median blood loss was 300 mL (range, 50–800 mL). The median number of harvested pelvic lymph nodes was 23.5 (range, 11–54). Two patients had positive surgical margins. Intraoperative complications occurred in 7 of the patients, and a conversion to open surgery was mandatory for 2 patients (conversion rate = 0.5%). Postoperative urinary tract fistula developed in 3 patients. Sixty-nine patients underwent adjuvant therapy. The median duration of follow-up was 31 months (range, 7–69 months). Thirty patients developed recurrent disease with a median disease-free interval of 12 months (range, 6–23 months), and 24 died of disease. The estimated 3-year overall survival rate was 94.9% in the women with a tumor ≤ IB1 and 81.3% in those with a tumor >IB1, and the 3-year progression-free survival rates were 94.1% and 79.6%, respectively. Conclusion LRH is adequate, safe, and feasible for women with cervical cancer, and it can be routinely used for the treatment of early-stage tumors as a primary modality.