title: Twelve-year experience with laparoscopic radical hysterectomy and pelvic lymphadenectomy in cervical cancer.
abstract: OBJECTIVE
  This study aims to evaluate the morbidity, oncological outcome, and prognostic factors of cervical cancer patients treated with laparoscopic radical hysterectomy and pelvic lymphadenectomy (LRH).
  
  
  METHODS
  Patients with cervical cancer undergoing LRH at the First People's Hospital of Foshan between August 1998 and March 2010 were enrolled in this study. The medical records were reviewed.
  
  
  RESULTS
  A total of 240 patients were identified. According to FIGO stage, the number of patients with stage Ia2, Ib1, Ib2, IIa, and IIb was 2, 163, 34, 35, and 6, respectively. The conversion rate was 1.25%. Intraoperative and postoperative complications occurred in 7.08% and 9.16% patients, respectively. Other medical problems included 74 cases (30%) of bladder dysfunction. Excluding the lost cases, the median follow-up of 221 cases was 35 months, and 5-year survival rate for Ia2, Ib1, Ib2, IIa was 100%, 82%, 66%, 60%, respectively. Univariate analysis showed factors impacting the survival rate were FIGO stage>Ib1, non-squamous histologic type, deep cervical stromal invasion, and lymph node metastasis (P=0.027, 0.023, 0.007, 0.000). The Cox-proportional hazards regression analysis indicated that only lymph node metastasis (OR=3.827, P=0.000) was independent of poor prognostic factor. The 5-year survival rates in Ib1 were 88% with negative lymph nodes and 59% with positive lymph nodes (P=0.000).
  
  
  CONCLUSIONS
  Our data demonstrate that LRH can be performed in stage Ia2-Ib1 or less advanced node negative cervical cancer patients without compromising survival. The feasibility of LRH for more advanced patients needs further investigations.
authors.affiliation: Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical College, 325000 Wenzhou, China.
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Yan
authors.forename: Guangyi
authors.initials: G
authors.lastname: Li
authors.forename: Huiling
authors.initials: H
authors.lastname: Shang
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.forename: Yubin
authors.initials: Y
authors.lastname: Han
authors.forename: Tiecheng
authors.initials: T
authors.lastname: Lin
authors.forename: Feiyun
authors.initials: F
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010388:Pelvis / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000601:surgery*