The LACC trial compared minimally invasive radical hysterectomy (MIS-RH) with open radical hysterectomy (open-RH) for early-stage cervical cancer. Its landmark finding was:

• A MIS-RH had superior disease-free survival with fewer complications
• B MIS-RH had inferior disease-free and overall survival compared to open-RH ✓
• C No difference in survival but significantly lower morbidity with MIS-RH
• D MIS-RH was superior for Stage IB1 but inferior for IB2

Explanation

The LACC (Laparoscopic Approach to Cervical Cancer) trial, published in 2018, was a landmark RCT that showed minimally invasive radical hysterectomy had significantly lower 4.5-year disease-free survival (91.2% vs. 97.1%) and higher recurrence rates compared to open radical hysterectomy for Stage IA2 and IB1 cervical cancer. This unexpected finding fundamentally changed practice; most centers now recommend open radical hysterectomy for early cervical cancer. The proposed mechanisms include uterine manipulator use causing tumor dissemination, CO2 pneumoperitoneum effects, and colpotomy technique. This trial essentially reversed the widespread adoption of laparoscopic radical hysterectomy.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.