Comparison between laparoscopic and abdominal radical hysterectomy for cervical adenosquamous carcinoma at stage IA2 to IIA2: A multicenter retrospective study

Authors：Teng, Xiaohui; Kang, Shan; Li, Weili; Ding, Hongmei; Ling, Bin; Zhu, Lin; Wang, Danbo; Lang, Jinghe; Liu, Ping; Chen, Chunlin^*

Source：JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, 2023, 49(6): 1592-1610.

DOI：10.1111/jog.15633

• cervical adenosquamous carcinoma
• disease-free survival
• laparoscopy
• overall survival
• radical hysterectomy

Objective: We aimed to compare the 5-year oncological outcomes of laparoscopic/abdominal radical hysterectomy (LRH/ARH) in patients with cervical adenosquamous carcinoma at stage IA2 to IIA2 based on the 2009 or 2018 International Federation of Gynecology and Obstetrics (FIGO) staging criteria.Methods: Based on the clinical diagnosis and treatment of cervical cancer in China (Four C) database, Cox risk regression models were applied to analyze tumor prognosis treated with ARH/LRH in FIGO 2009 and 2018 IA2-IIA2 patients and stratified findings according to tumor diameter (<= 4 and > 4 cm subgroups). And to avoid bias, propensity score matching (PSM) was also used for the cohort study.Results: Based on FIGO 2009 staging criteria (n = 474), there was no significant difference between the ARH and LRH groups in 5-year disease-free survival (DFS) or overall survival (OS). Lymph node metastasis was a risk factor for 5-year DFS in this stage. After PSM, lymphovascular space invasion (LVSI) was an independent risk factor for 5-year OS in the tumors & LE;4 cm subgroup. Based on FIGO2018 staging criteria (n = 322), cervical interstitial infiltration depth was an independent risk factor for 5-year OS in the total population and the tumor diameter & LE;4 cm subgroup.Conclusions: Laparoscopic surgery was not a risk factor affecting the oncologic prognosis of adenosquamous carcinoma of the cervix based on either FIGO 2009 or 2018 staging of stage IA2-IIA2. In addition, LRH may be considered for patients with early-stage cervical adenosquamous carcinoma.

• Institution
  中国医学科学院; 南方医科大学; 河北医科大学; 山东大学; 中国医学科学院北京协和医院