Minimally Invasive versus Abdominal Radical Hysterectomy for Cervical Cancer (LACC Trial)

Type: Cervical

Section: Surgery for cervical cancer

Published: November 2018

This paper compares survival outcomes for women who had a radical hysterectomy through laparoscopic (keyhole) surgery or open (through an incision on the abdomen) surgery for early stage cancer of the cervix.
This study was a randomised controlled trial of more than 600 women with early stage cervical cancer. Women who were eligible for the study were randomly assigned to either have a radical hysterectomy via keyhole surgery or through an incision on their abdomen.

A radical hysterectomy involves surgical removal of the uterus, fallopian tubes, parametria (the tissue which connects the cervix to the walls of the pelvis) and the upper one third of the vagina with or without some or all of the pelvic lymph nodes.

The study was stopped slightly earlier than planned as they discovered a surprise finding that those who had keyhole surgery were more likely to have their cancer come back or die in the years after surgery than those who had open surgery.

Since the publication of this study, most centres have moved away from performing radical hysterectomy via keyhole surgery. For some patients with small tumours (<2cm in size) keyhole surgery may still be considered as very few patients with this size of tumour were included in the study.