title: Retrospective comparison of laparoscopic versus open radical hysterectomy after neoadjuvant chemotherapy for locally advanced cervical cancer.
abstract: OBJECTIVE
  To compare outcomes after laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for locally advanced cervical cancer (LACC)after neoadjuvant chemotherapy (NACT).
  
  
  METHODS
  In a retrospective study, data were analyzed from patients with FIGO stage IB2-IIB cervical cancer who underwent LRH or ARH after NACT at Union Hospital, Wuhan, China, between January 2007 and August 2013.Perioperative outcomes and survival were compared.
  
  
  RESULTS
  Overall, 99 patients who underwent LRH and 30 who underwent ARH were included. Compared with ARH patients, LRH patients presented with lower-stage tumors (P=0.013). Median operative time, number of harvested lymph nodes, and rate of positive surgical margins did not differ significantly between the groups, but LRH resulted in less blood loss (median 300mL [range 20-1100] vs 375mL [100-1200]; P=0.027). There were two intraoperative complications and 23 postoperative complications in the LRH group, and 12 postoperative complications in the ARH group. No conversions occurred in the LRH group; all complications were managed without severe sequelae. As of March 2014, recurrence had been noted for 6(6.1%) LRH patients and 2 (6.7%) ARH patients.
  
  
  CONCLUSIONS
  LRH was similar to ARH in terms of safety, feasibility, and morbidity, with less blood loss among women with LACC undergoing NACT. Long-term outcomes need to be documented.
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Cai
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Dong
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Hongbo
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Zhoufang
authors.initials: Z
authors.lastname: Xiong
authors.affiliation: Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: zehuawang@163.net.
authors.forename: Zehua
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*
keywords: Abdominal radical hysterectomy; Laparoscopic radical hysterectomy; Locally advanced cervical cancer; Neoadjuvant chemotherapy