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

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

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, fewer transfusions, 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.

Original languageEnglish
Pages (from-to)788-796
Number of pages9
JournalCancer Research and Treatment
Volume51
Issue number2
DOIs
StatePublished - 1 Jan 2019

Fingerprint

Hysterectomy
Uterine Cervical Neoplasms
Survival
Morbidity
Costs and Cost Analysis
Propensity Score
Minimally Invasive Surgical Procedures
Laparoscopy
Length of Stay
Databases
Confidence Intervals

Keywords

  • Laparoscopy
  • Minimally invasive surgery
  • Radical hysterectomy
  • Uterine cervical neoplasms

Cite this

Kim, Jin Hee ; Kim, Kyungjoo ; Park, Seo Jin ; Lee, Jung Yun ; Kim, Kidong ; Lim, Myong Cheol ; Kim, Jae Weon. / Comparative effectiveness of abdominal versus laparoscopic radical hysterectomy for cervical cancer in the postdissemination era. In: Cancer Research and Treatment. 2019 ; Vol. 51, No. 2. pp. 788-796.
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abstract = "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, fewer transfusions, 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.",
keywords = "Laparoscopy, Minimally invasive surgery, Radical hysterectomy, Uterine cervical neoplasms",
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Comparative effectiveness of abdominal versus laparoscopic radical hysterectomy for cervical cancer in the postdissemination era. / Kim, Jin Hee; Kim, Kyungjoo; Park, Seo Jin; Lee, Jung Yun; Kim, Kidong; Lim, Myong Cheol; Kim, Jae Weon.

In: Cancer Research and Treatment, Vol. 51, No. 2, 01.01.2019, p. 788-796.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparative effectiveness of abdominal versus laparoscopic radical hysterectomy for cervical cancer in the postdissemination era

AU - Kim, Jin Hee

AU - Kim, Kyungjoo

AU - Park, Seo Jin

AU - Lee, Jung Yun

AU - Kim, Kidong

AU - Lim, Myong Cheol

AU - Kim, Jae Weon

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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, fewer transfusions, 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.

AB - 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, fewer transfusions, 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.

KW - Laparoscopy

KW - Minimally invasive surgery

KW - Radical hysterectomy

KW - Uterine cervical neoplasms

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VL - 51

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JF - Cancer Research and Treatment

SN - 1598-2998

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