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Comparative Effectiveness of Abdominal versus Laparoscopic Radical Hysterectomy for Cervical Cancer in the Postdissemination Era

 Jin Hee Kim  ;  Kyungjoo Kim  ;  Seo Jin Park  ;  Jung-Yun Lee  ;  Kidong Kim  ;  Myong Cheol Lim  ;  Jae Weon Kim 
 CANCER RESEARCH AND TREATMENT, Vol.51(2) : 788-796, 2019 
Journal Title
Issue Date
Combined Modality Therapy ; Female ; Humans ; Hysterectomy*/adverse effects ; Hysterectomy*/methods ; Laparoscopy*/adverse effects ; Laparoscopy*/methods ; Neoplasm Staging ; Odds Ratio ; Republic of Korea ; Safety Management ; Treatment Outcome ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/mortality ; Uterine Cervical Neoplasms/surgery*
Laparoscopy ; Minimally invasive surgery ; Radical hysterectomy ; Uterine cervical neoplasms
PURPOSE: Despite the benefits of minimally invasive surgery for cervical cancer, there are a lack of randomized trials comparing laparoscopic radical hysterectomy and abdominal radical hysterectomy. We compared morbidity, cost of care, and survival between abdominal radical hysterectomy and laparoscopic radical hysterectomy for cervical cancer. Materials and Methods: We used the Korean nationwide database to identify women with cervical cancer who underwent radical hysterectomy from January 1, 2011 to December 31, 2014. Patients who underwent abdominal radical hysterectomy were compared to those who underwent laparoscopic radical hysterectomy. Perioperative morbidity, the use of adjuvant therapy, and survival were evaluated after propensity score balancing. RESULTS: We identified 6,335 patients, including 3,235 who underwent abdominal radical hysterectomy and 3,100 who underwent laparoscopic radical hysterectomy. The use of laparoscopic radical hysterectomy increased from 46.1% in 2011 to 51.8% in 2014. Patients who were younger, had a more recent year of diagnosis, and were treated in the metropolitan area were more likely to undergo a laparoscopic procedure (p < 0.001). Compared to abdominal radical hysterectomy, laparoscopic radical hysterectomy was associated with lower rates of complication, fewertransfusions, a shorter hospital stay, less adjuvant therapy, and reduced total medical costs (p < 0.001). Laparoscopic surgery was associated with a better overall survival than abdominal operation (hazard ratio, 0.74; 95% confidence interval, 0.64 to 0.85). CONCLUSION: In the postdissemination era, laparoscopic radical hysterectomy was associated with more favorable morbidity profiles, a lower cost of care, and comparable survival than abdominal radical hysterectomy.
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1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Jung-Yun(이정윤) ORCID logo https://orcid.org/0000-0001-7948-1350
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