Laparoscopic radical hysterectomy for invasive cervical cancer: 8-year experience of a pilot study

Objectives. The aim of this study was to retrospectively evaluate, in a series of 50 consecutive patients, the feasibility, morbidity, and survival outcome of the laparoscopic radical hysterectomy for carcinoma of the uterine cervix. Methods. Fifty patients with invasive cervical cancer were operated on by laparoscopic radical hysterectomy between 1993 and 2001 at two cancer centers. Patients in a good general condition with a cervical carcinoma less than 4 cm and a body mass index up to 29 were eligible. Thirty-one patients had prior brachytherapy. Results. The median overall operative time was 258 min. The mean number of harvested pelvic external iliac nodes was 13.22 per patient. The median postoperative hospital stay was 7.5 days. Two patients had major urinary complications; one had a bladder fistula and one a ureteral stenosis. The median follow-up was 44 months. The overall 5-year survival rate of FIGO stage Ia2 and Ib1 patients was 96%. Conclusions. Our results demonstrate that radical hysterectomy can be performed by laparoscopy in stage IB1 or less advanced node negative cervical cancer patients without compromising survival. Prior brachytherapy did not affect the feasibility of this radical procedure. (C) 2003 Elsevier Inc. All rights reserved.