LAUSR

Introduction/Background The main limitation of LACC trial is that the surgeon validation criteria for laparoscopic radical hysterectomy was not enough to include surgeons who completed learning curve for laparoscopic radical hysterectomy. So, the comparison between open and laparoscopic surgery was unfair. In addition, there was no safety measure to reduce intraperitoneal tumor exposure during laparoscopic radical hysterectomy. The aim of this study was to compare the survival outcomes between laparoscopic versus open radical hysterectomy in early cervical cancer after completing learning curve and reducing intraperitoneal tumor exposure. Methodology This was a retrospective study including patients with stage IA2 - IIA2 cervical cancer who underwent laparoscopic or open radical hysterectomy. All surgeons completed the learning curve for laparoscopic radical hysterectomy. To reduce the intraperitoneal tumor exposure during laparoscopic radical hysterectomy, all broken tumor tissues were washed out before colpotomy, and colpotomy and stump repair has been performed transvaginally. The survival outcomes were compared between laparoscopic and open radical hysterectomy. Results During the study period, 859 and 1388 patients underwent open and laparoscopic radical hysterectomy, respectively. The 5-year DFS and OS did not differ between laparoscopic and open radical hysterectomy. The survival outcomes did not differ between laparoscopic and open radical hysterectomy both in patients with tumor <4 cm and with tumor >4 cm. The use of laparscopic surgery increased gradually and has become the main surgical approach during the study period. Each year’s survival rate was not compromised despite the increased use of laparoscopic radical hysterectomy. Conclusion The survival outcome of laparoscopic radical hysterectomy is comparable to open radical hysterectomy after completing learning curve and reducing intraperitoneal tumor exposure during surgery. Disclosure Nothing to disclose.