Laparoscopic Versus Abdominal Radical Hysterectomy for Cervical Cancer

Abstract

Background: Laparoscopic radical hysterectomy (LRH) and open abdominal radical hysterectomy (ARH) have been used for cervical cancer treatment. We aimed to perform a meta-analysis to compare the efficacy and safety of LRH and ARH in the treatment of cervical cancer to provide reliable evidence to the clinical cervical cancer treatment.Methods: Two investigators independently searched PubMed and other databases for randomized controlled trials (RCTs) comparing LRH and ARH for cervical cancer treatment up to May 31, 2022. The risk of bias assessment tool recommended by Cochrane library was used for quality assessment. RevMan 5.3 software was used for meta-analysis.Results: Fourteen RCTs with a total of 1700 patients with cervical cancer were finally included. Meta-analyses indicated that compared with ARH, LRH reduced the intraoperative blood loss (mean difference [MD]

Laparoscopic Versus Abdominal Radical Hysterectomy

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with interest the systematic review and meta-analysis evaluating randomized controlled trials (RCTs) comparing laparoscopic versus abdominal radical hysterectomy for cervical cancer. 1 The authors collected data from 14 RCTs comparing minimally invasive (laparoscopic and robotic-assisted) and open abdominal approaches in patients affected by cervical cancer. 1 Based on the cumu-

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“…2 The other 2 trials published in English-language, are not providing useful information regarding oncologic safety. 1 The study by Campos et al, included 30 patients. 3 In the paper from Benedetti et al, 4 all the patients had an open abdominal radical hysterectomy (the laparoscopic approach was used only for lymphadenectomy).…”

“…3 In the paper from Benedetti et al, 4 all the patients had an open abdominal radical hysterectomy (the laparoscopic approach was used only for lymphadenectomy). 1 Unfortunately, we are not able to look in deep into other trials, published in the Chinese language. 1 Moreover, would be interesting to evaluate how surgical approaches influenced survival endpoints, over time (not looking just at the crude number of events).…”

“…1 Unfortunately, we are not able to look in deep into other trials, published in the Chinese language. 1 Moreover, would be interesting to evaluate how surgical approaches influenced survival endpoints, over time (not looking just at the crude number of events). Although several well-designed retrospective studies 2,5,6 questioned the LACC trial, the role of minimally invasive radical hysterectomy is still under debate.…”

“…We read with interest the systematic review and meta-analysis evaluating randomized controlled trials (RCTs) comparing laparoscopic versus abdominal radical hysterectomy for cervical cancer 1. The authors collected data from 14 RCTs comparing minimally invasive (laparoscopic and robotic-assisted) and open abdominal approaches in patients affected by cervical cancer 1. Based on the cumulative results of the RCTs, the authors concluded that, although further long-term evidence is needed, the laparoscopic approach correlates with more advantages over open abdominal radical hysterectomy 1.…”