Practice patterns and 90-day treatment-related morbidity in early-stage cervical cancer

• Published in: Gynecologic oncology 2022-09, Vol.166 (3), p.561-566
• Main Authors: Scambia, Giovanni, Landoni, Fabio, Ghezzi, Fabio, Muzii, Ludovico, Panici, Pierluigi Benedetti, Raspagliesi, Francesco, Donato, Violante Di, Casarin, Jvan, Di Martino, Giampaolo, Grassi, Tommaso, De Iaco, Pierandrea, Berretta, Roberto, Zupi, Errico, Centini, Gabriele, Pellegrino, Antonio, Corso, Silvia, Stevenazzi, Guido, Boschi, Anna Chiara, Comerci, Giuseppe, Greco, Pantaleo, Scutiero, Gennaro, Sopracordevole, Francesco, Giorda, Giorgio, Fichera, Mariasole, Caretto, Marta, Sartori, Enrico, Ferrari, Federico, Cianci, Antonio, Sarpietro, Giuseppe, Giampaolino, Pierluigi, Bifulco, Giuseppe, Morelli, Michele, Dio, Michele Di, Ferrero, Annamaria, Biglia, Nicoletta, Barra, Fabio, Ferrero, Simone, Cianci, Stefano, Chiantera, Vito, Ercoli, Alfredo, Schettini, Sergio, Orlando, Teresa, Ettore, Giuseppe, Puppo, Andrea, Olearo, Elena, Leone Roberti Maggiore, Umberto, Artuso, Valeria, D'Augè, Tullio Golia, Cuccu, Ilaria, Fischetti, Margherita, Casorelli, Assunta, Giannini, Andrea, D’Oria, Ottavia, Restaino, Stefano, Bergamini, Alice, Bocciolone, Luca, Plotti, Francesco, Angioli, Roberto, Mantovani, Giulia, Ceccaroni, Marcello, Cassini, Chiara, Dominoni, Mattia, Giambanco, Laura, Amodeo, Silvia, Leo, Livio, Thommaset, Raphaël, Raimondo, Diego, Seracchioli, Renato, Malzoni, Mario, Falcone, Francesca, Gorlero, Franco, Di Luca, Martina, Busato, Enrico, Kilzie, Sami, Dell'Acqua, Andrea, Scarfone, Giovanna, Vercellini, Paolo, Petrillo, Marco, Sorbi, Flavia, Ricci, Giuseppe, Damiani, Gianluca Raffaello, Consonni, Roberto, Di Lorenzo, Nadia, Lippolis, Antonio, Aguzzoli, Lorenzo, Palomba, Stefano, Tripodi, Marcello, Calandra, Davide, Pellegrini, Franco, Zullo, Fulvio, Surico, Daniela, Remorgida, Valentino, Ruscitto, Francesco, Beretta, Paolo
• Format: Article
• Language: English
• Subjects: Complications; Laparoscopy; Morbidity; Radical hysterectomy
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2022.07.022

To evaluate the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial on patterns of care and surgery-related morbidity in early-stage cervical cancer. This is a retrospective, a multi-institutional study evaluating 90-day surgery-related outcomes of patients undergoing treatment for early-stage cervical cancer before (period I: 01/01/2016–06/01/2018) and after (period II: 01/01/2019–06/01/2021) the publication of the results of the LACC trial. Charts of 1295 patients were evaluated: 581 (44.9%) and 714 (55.1%) before and after the publication of the LACC trial, respectively. After the publication of the LACC trial, the number of patients treated with minimally invasive radical hysterectomy decreased from 64.9% to 30.4% (p < 0.001). Overall, 90-day complications occurred in 110 (18.9%) and 119 (16.6%) patients in the period I and period II, respectively (p = 0.795). Similarly, the number of severe (grade 3 or worse) complications did not differ between the two periods (38 (6.5%) vs. 37 (5.1%); p = 0.297). Overall and severe 90-day complications were consistent between periods even evaluating stage IA (p = 0.471), IB1 (p = 0.929), and IB2 (p = 0.074), separately. The present investigation highlighted that in referral centers the shift from minimally invasive to open radical hysterectomy does not influence 90-day surgery-related morbidity. •The publication of the LACC trial determined a shift from the use of minimally invasive to open surgery.•Overall and severe 90-day complication rates were not influenced by the surgical approach.•The paradigm shift from minimally invasive to open radical hysterectomy does not increase the complication rate.