Comparative Effectiveness of Abdominal versus Laparoscopic Radical Hysterectomy for Cervical Cancer in the Postdissemination Era / Journal of the Korean Cancer Association, 대한암학회지
Cancer Research and Treatment
;
: 788-796, 2019.
Article
in English
| WPRIM
| ID: wpr-763117
ABSTRACT
PURPOSE:
Despite the benefits of minimally invasive surgery for cervical cancer, there are a lack of randomized trials comparing laparoscopic radical hysterectomy and abdominal radical hysterectomy. We compared morbidity, cost of care, and survival between abdominal radical hysterectomy and laparoscopic radical hysterectomy for cervical cancer. MATERIALS ANDMETHODS:
We used the Korean nationwide database to identify women with cervical cancer who underwent radical hysterectomy from January 1, 2011 to December 31, 2014. Patients who underwent abdominal radical hysterectomy were compared to those who underwent laparoscopic radical hysterectomy. Perioperative morbidity, the use of adjuvant therapy, and survival were evaluated after propensity score balancing.RESULTS:
We identified 6,335 patients, including 3,235 who underwent abdominal radical hysterectomy and 3,100 who underwent laparoscopic radical hysterectomy. The use of laparoscopic radical hysterectomy increased from 46.1% in 2011 to 51.8% in 2014. Patients who were younger, had a more recent year of diagnosis, and were treated in the metropolitan area were more likely to undergo a laparoscopic procedure (p < 0.001). Compared to abdominal radical hysterectomy, laparoscopic radical hysterectomy was associated with lower rates of complication, fewertransfusions, a shorter hospital stay, less adjuvant therapy, and reduced total medical costs (p < 0.001). Laparoscopic surgery was associated with a better overall survival than abdominal operation (hazard ratio, 0.74; 95% confidence interval, 0.64 to 0.85).CONCLUSION:
In the postdissemination era, laparoscopic radical hysterectomy was associated with more favorable morbidity profiles, a lower cost of care, and comparable survival than abdominal radical hysterectomy.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Uterine Cervical Neoplasms
/
Laparoscopy
/
Minimally Invasive Surgical Procedures
/
Diagnosis
/
Propensity Score
/
Hysterectomy
/
Length of Stay
Type of study:
Controlled clinical trial
/
Diagnostic study
/
Prognostic study
Limits:
Female
/
Humans
Language:
English
Journal:
Cancer Research and Treatment
Year:
2019
Type:
Article
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