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Article

Laparoscopic Lymph Node Assessment Prior to Open Radical Hysterectomy—A Two-Center Retrospective Study on Individualized Surgical Management of Early-Stage Cervical Cancer

by
Magdalena Postl
1,
Christoph Grimm
1,*,
Melina Danisch
1,
Patrik Petrov
1,
Mara Mantovan
2,
Alexander Reinthaller
1,
Eva Langthaler
3,
Stephan Polterauer
1,
Christian Marth
2,
Nicole Concin
1 and
Alain Gustave Zeimet
2
1
Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecological Oncology, Comprehensive Cancer Center, Gynecologic Cancer Unit, Medical University of Vienna, 1090 Vienna, Austria
2
Department of Obstetrics and Gynecology, Medical University Innsbruck, 6020 Innsbruck, Austria
3
Department of Pathology, Medical University Vienna, 1090 Vienna, Austria
*
Author to whom correspondence should be addressed.
J. Pers. Med. 2026, 16(9), 475; https://doi.org/10.3390/jpm16090475
Submission received: 24 July 2026 / Revised: 2 September 2026 / Accepted: 9 September 2026 / Published: 15 September 2026
(This article belongs to the Section Personalized Therapy in Clinical Medicine)
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Abstract

Background/Objectives: Recent evidence suggests open radical hysterectomy is safer than radical hysterectomy by minimally invasive surgery (MIS) in early-stage cervical cancer. This study evaluated the oncological safety of laparoscopic lymph node assessment followed by open radical hysterectomy and the rate of unnecessary laparotomies avoided compared with a completely open approach. Methods: This two-center retrospective study included patients with cervical cancer FIGO stage ≤ Ib3 treated at two Austrian centers between 2015 and 2023. Patients undergoing laparoscopic lymph node assessment followed by open radical hysterectomy were compared with a matched historical cohort treated with primary open surgery between 2012 and 2017. Recurrence rates and progression-free survival (PFS) were compared using univariate and multivariate analyses. Results: In total, 130 patients were included: 79 (60.8%) underwent the combined approach and 51 (39.2%) the completely open approach. Recurrence rates (10.1% vs. 5.9%, p = 0.53) and median PFS (p = 0.36; median 26.0 vs. 71.3 months) did not differ between the two approaches. All patients underwent thorough preoperative radiologic and clinical assessment without suspected nodal metastases and were scheduled for radical hysterectomy with prior nodal assessment by MIS or open surgery. Intraoperative lymph node metastases were incidentally detected in 21/130 (16.2%) patients (combined approach n = 12 [15.2%] vs. open approach n = 9 [17.6%]). In cases of positive lymph nodes, surgery was abandoned without performing open radical hysterectomy and patients were referred to chemoradiotherapy. The needed to treat number to prevent one unnecessary open surgery was 6.25. Conclusions: Laparoscopic lymph node assessment before open radical hysterectomy appears oncologically safe, with comparable recurrence rates and PFS, and could spare one unnecessary laparotomy in every 7th patient with early-stage cervical cancer undergoing the combined approach.
Keywords: uterine cervical neoplasms; early-stage cervical cancer; radical hysterectomy; laparoscopy; surgical staging; lymphatic metastasis; laparotomy; progression-free survival; chemoradiotherapy uterine cervical neoplasms; early-stage cervical cancer; radical hysterectomy; laparoscopy; surgical staging; lymphatic metastasis; laparotomy; progression-free survival; chemoradiotherapy

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MDPI and ACS Style

Postl, M.; Grimm, C.; Danisch, M.; Petrov, P.; Mantovan, M.; Reinthaller, A.; Langthaler, E.; Polterauer, S.; Marth, C.; Concin, N.; et al. Laparoscopic Lymph Node Assessment Prior to Open Radical Hysterectomy—A Two-Center Retrospective Study on Individualized Surgical Management of Early-Stage Cervical Cancer. J. Pers. Med. 2026, 16, 475. https://doi.org/10.3390/jpm16090475

AMA Style

Postl M, Grimm C, Danisch M, Petrov P, Mantovan M, Reinthaller A, Langthaler E, Polterauer S, Marth C, Concin N, et al. Laparoscopic Lymph Node Assessment Prior to Open Radical Hysterectomy—A Two-Center Retrospective Study on Individualized Surgical Management of Early-Stage Cervical Cancer. Journal of Personalized Medicine. 2026; 16(9):475. https://doi.org/10.3390/jpm16090475

Chicago/Turabian Style

Postl, Magdalena, Christoph Grimm, Melina Danisch, Patrik Petrov, Mara Mantovan, Alexander Reinthaller, Eva Langthaler, Stephan Polterauer, Christian Marth, Nicole Concin, and et al. 2026. "Laparoscopic Lymph Node Assessment Prior to Open Radical Hysterectomy—A Two-Center Retrospective Study on Individualized Surgical Management of Early-Stage Cervical Cancer" Journal of Personalized Medicine 16, no. 9: 475. https://doi.org/10.3390/jpm16090475

APA Style

Postl, M., Grimm, C., Danisch, M., Petrov, P., Mantovan, M., Reinthaller, A., Langthaler, E., Polterauer, S., Marth, C., Concin, N., & Zeimet, A. G. (2026). Laparoscopic Lymph Node Assessment Prior to Open Radical Hysterectomy—A Two-Center Retrospective Study on Individualized Surgical Management of Early-Stage Cervical Cancer. Journal of Personalized Medicine, 16(9), 475. https://doi.org/10.3390/jpm16090475

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