From University Hospitals: In a Correspondence article published in yesterday's issue of the New England Journal of Medicine, researchers from University Hospitals (UH) Cleveland Medical Center and New York Presbyterian Hospital – Weill Cornell Medicine in New York, found a substantial reduction in the use of minimally invasive surgery for cervical cancer after publication of the results a major study called the Laparoscopic Approach to Cervical Cancer (LACC) in November 2018.
The earlier study, which compared minimally invasive surgery with open abdominal radical hysterectomy in patients with early-stage cervical cancer, found minimally invasive surgery to be associated with worse disease-free and overall survival than open surgery. As a result of that study and other related studies, many guidelines recommended that surgeons use open surgery rather than minimally invasive surgery.
In the new article, the researchers sought to answer the extent to how practice changed by studying the records of 2,437 patients at 283 medical centers, ultimately finding a dramatic decrease in the use of minimally invasive surgery following the LACC Trial publication.
Jonathan Shoag, MD, senior author of the study, urologic oncologist from the UH Urology Institute and member of the Case Comprehensive Cancer Center said that the odds were still higher for minimally invasive surgery at a non-academic medical center compared with an academic medical center; 0.81 versus 0.27. He said the results of the new study suggest an opportunity to improve outcomes at non-academic medical centers.