Outcomes better with open hysterectomy for early cervical cancer

Open surgery for radical hysterectomy offers early-stage cervical cancer patients a lower recurrence rate and a higher disease-free survival rate at 4.5 years than a minimally invasive surgical approach, according to the final results of the Laparoscopic Approach to Cervical Cancer (LACC) study presented at the Society of Gynecologic Oncology's Annual Meeting on Women's Cancer, held from March 18 to 21 in Phoenix.

Pedro Ramirez, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues reported overall survival outcomes and subgroup analysis of 631 patients with early-stage cervical cancer who completed surveillance 4.5 years after radical hysterectomy (319 minimally invasive surgery [MIS] and 312 open surgery).

The researchers found that the rate of disease-free survival was lower for MIS than open surgery (13.5 percent of MIS patients had disease at 4.5 years versus 3.5 percent of open surgery patients). MIS was associated with four-times higher recurrence rates versus the open approach.

"This final analysis of results from the LACC trial demonstrate that, despite being more invasive, open surgery offers these patients a lower recurrence rate and a better chance of disease-free survival than minimally invasive surgical approaches," Ramirez said in a statement. "Our results from this subgroup analysis suggest that the likely reason for worse outcomes in patients who undergo MIS is tumor spillage or contamination, as worse outcomes are accentuated in patients with larger tumors and the rates of carcinomatosis are significantly higher in the MIS group."

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