Open Versus Laparoscopic Radical Hysterectomy Using Myoma Screw for Early-Stage Cervical Cancer- A Retrospective...

This study was undertaken to compare and report oncological outcomes of our technique of laparoscopic radical hysterectomy (lap RH) using myoma screw with open radical hysterectomy (RH) for early-stage cervical cancer. This was a retrospective analysis of a prospectively maintained database of early-stage cervical cancer patients undergoing open or lap RH. The clinico-pathological data in the form of age, FIGO (2009) stage, type of surgery, lymph node yield, number of positive lymph nodes, margin status, adjuvant radiation, time and pattern of recurrence and 5-year overall survival data were collected. Out of the 129 eligible patients, 92 underwent open and 37 lap RH. Both groups were comparable in terms of baseline clinico-pathological characteristics, except that the lap group had significantly more low FIGO (2009) stage patients. There was no significant difference in the lymph node yield, lymph node positivity or vaginal cut margin status. The need for adjuvant radiation was higher in the open group (54.4% vs. 8.1%, p < 0.001). Twenty-eight patients (30.4%) in the open group and 11 patients (29.7%) in the laparoscopic group developed recurrence (p = 0.7). There was no difference in the rate, pattern or time to recurrence. There were 22 deaths in the open and seven in the laparoscopic group. The 5-year survival probability for lap RH was 74.6% (95% CI 56.8 to 85.9%) and for open was 75.4% (95% CI 64.6 to 83.3%). Lap RH using myoma screw is an oncologically safe technique in carefully selected patients and can be offered to early-stage cervical cancer.