title: Laparoscopic versus open radical hysterectomy in early-stage cervical cancer: long-term survival outcomes in a matched cohort study.
abstract: BACKGROUND
  To compare the long-term survival outcomes between laparoscopic radical hysterectomy (LRH) and open radical hysterectomy (ORH).
  
  
  METHODS
  We matched patients with stage IA2 to IIA cervical cancer with known risk factors for recurrence who underwent ORH and LRH.
  
  
  RESULTS
  Compared with ORH (n = 263), LRH (n = 263) did not have higher risks of recurrence [hazard ratio (HR) = 1.28; 95% confidence interval (CI) 0.62-2.64] or death (HR = 1.46; 95% CI 0.62-3.43). Even in patients with tumors >2 cm in diameter, the risks of recurrence (HR = 0.82; 95% CI 0.31-2.16) or death (HR = 1.01; 95% CI 0.35-2.95) were not higher for LRH than for ORH. The LRH and ORH group had 5-year recurrence-free survival rates of 92.8% and 94.4%, respectively (P = 0.499). LRH resulted in significantly lower estimated blood loss (379.6 versus 541.1 ml, P < 0.001) and shorter postoperative hospital stay (12.5 versus 20.3 days, P < 0.001). Intraoperative complication rates were similar in the two groups (6.8% versus 5.7%, P = 0.711), but postoperative complication rate was lower in the LRH than in the ORH group (9.2% versus 21%, P < 0.001).
  
  
  CONCLUSIONS
  LRH is an oncologically safe alternative to ORH and was associated with fewer postoperative complication and earlier recovery.
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. jhnam@amc.seoul.kr
authors.forename: J-H
authors.initials: JH
authors.lastname: Nam
authors.forename: J-Y
authors.initials: JY
authors.lastname: Park
authors.forename: D-Y
authors.initials: DY
authors.lastname: Kim
authors.forename: J-H
authors.initials: JH
authors.lastname: Kim
authors.forename: Y-M
authors.initials: YM
authors.lastname: Kim
authors.forename: Y-T
authors.initials: YT
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*