Cervical cancer survival rate after abdominal vs. laparoscopic radical hysterectomy in two government hospitals in Jakarta, Indonesia

Introduction: Cervical cancer ranks among the top ten globally. Its five-year survival rate is 67.9% across all stages. In Indonesia, laparoscopic radical hysterectomy (LRH) is gaining traction but remains less common than abdominal radical hysterectomy (ARH). Limited research exists on cervical cancer survival rates in Indonesia. Our study compared ARH to LRH survival rates for cervical cancer patients. Materials and Methods: We reported a retrospective study that included 275 patients of all cervical cancer stages who met inclusion criteria from 2015 to 2019 in two of Jakarta's national teaching hospitals. The patients underwent ARH or LRH, radiotherapy, and chemotherapy and were observed for five years. Univariate and multivariate analyses were performed to investigate survival rates. Results: 236 patients underwent ARH, and 39 patients underwent LRH. The median survival of LRH and ARH were 23.9 months and 29.6 months, respectively. The five-year survival rates of LRH and ARH patients were 75.0 % and 83.5%, respectively. The early-stage survival rate was higher than in the advanced stage (76.7% vs. 73.5%, p=0.006). Cox multivariate modelling determined that surgical approach (ARH vs. LRH) (HR: 2.3; 95% CI: 1.2-4.5; p = 0.01) and cancer stage (HR: 1.9; 95% CI: 1.18 – 2.92; p = 0.007) were significant factors. Conclusion: The higher cancer stage resulted in a lower five-year survival rate. In this limited sample study, LRH demonstrated an inferior five-year survival rate compared to ARH.