title: Comparative study of laparoscopico-vaginal radical hysterectomy and abdominal radical hysterectomy in patients with early cervical cancer.
abstract: OBJECTIVE
  The objective of this study was to compare the outcomes of patients treated by laparoscopico-vaginal (modified) radical hysterectomy (LVMRH) to those of patients treated by abdominal radical hysterectomy (RH).
  
  
  METHODS
  From 1997 to 2002, we performed 37 cases of LVMRH + pelvic lymph node dissection (PLND) and 47 cases of laparoscopico-vaginal radical hysterectomy (LVRH) with paraaortic lymph node sampling + PLND. Inclusion criteria for the laparoscopic surgery were patients with FIGO stage IA1 to IB1, for exocervical mass of grossly less than 2 cm. As a control, we selected 46 cases for MRH group and 96 cases for RH group.
  
  
  RESULTS
  Operating time, the number of lymph nodes obtained and the rate of complications were similar in both groups. The hospital stay was significantly shorter in laparoscopic group. Four (8.5%) of 47 LVRH patients and 2 (2.1%) of 96 RH patients had recurrences. Recurrence-free survival in RH group was significantly higher than LVRH group (P = 0.0194). In LVRH group, patients with large tumor volume (>or=4.2 cm(3)) had significantly higher recurrence rate of 42.9% (3/7) than those with small volume (1/40) (P = 0.0021). The 3-year progression-free survivals were 97.1% in LVRH group (<4.2 cm(3)) and 98.9% in RH group.
  
  
  CONCLUSIONS
  Laparoscopic surgery for the treatment of early cervical cancer is a safe and effective alternative to conventional RH. Considering the higher recurrence rate in patients with large tumor volume, it would be better if laparoscopic surgery is limited to patients with small volume disease (tumor diameter <2 cm or volume <4.2 cm(3)).
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, 138-736, Seoul, South Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Nam
authors.forename: Jong Hyeok
authors.initials: JH
authors.lastname: Kim
authors.forename: Dae Yeon
authors.initials: DY
authors.lastname: Kim
authors.forename: Mi Kyung
authors.initials: MK
authors.lastname: Kim
authors.forename: Hang Jo
authors.initials: HJ
authors.lastname: Yoo
authors.forename: Yong Man
authors.initials: YM
authors.lastname: Kim
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Kim
authors.forename: Jung-Eun
authors.initials: JE
authors.lastname: Mok
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*