Laparoscopic versus open radical hysterectomy for elderly patients with early-stage cervical cancer

Am J Obstet Gynecol. 2012 Sep;207(3):195.e1-8. doi: 10.1016/j.ajog.2012.06.081. Epub 2012 Jul 10.

Abstract

Objective: We sought to compare surgical and survival outcomes of laparoscopic radical hysterectomy (LRH) vs open radical hysterectomy (ORH) in elderly patients with early-stage cervical cancer.

Study design: A retrospective analysis was performed on elderly patients (≥65 years) who underwent either LRH (n = 99) or ORH (n = 159) due to stage IA2-IIA2 cervical cancer.

Results: One patient (1%) in LRH group required conversion to laparotomy. Operating time (P = .035), estimated blood loss (P = .002), recovery of bowel movement (P < .001), and postoperative hospital stay (P < .001) were significantly shorter or lower in LRH group. Postoperative complications were significantly less frequent in LRH group (P = .026). After the median follow-up time of 45 months, the 5-year disease-free survival (95% vs 93%, P = .350) and overall survival (96% vs 95%, P = .361) did not differ between LRH and ORH groups.

Conclusion: Elderly patients tolerated well both LRH and ORH. LRH was associated with better surgical outcomes compared to ORH without increasing intraoperative complications or decreasing survival.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Hysterectomy / methods*
  • Laparoscopy*
  • Neoplasm Staging
  • Retrospective Studies
  • Survival Rate
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*