The LACC trial (2018) compared minimally invasive radical hysterectomy to open radical hysterectomy for early-stage cervical cancer. What was the principal finding that changed surgical practice?

• A Minimally invasive surgery had higher surgical complication rates, so open surgery was preferred
• B Both approaches had equivalent survival but minimally invasive surgery reduced blood loss significantly
• C Open surgery was associated with more lymph node retrieval but similar recurrence rates
• D Minimally invasive surgery had significantly lower disease-free and overall survival compared to open surgery ✓

Explanation

The LACC (Laparoscopic Approach to Cervical Cancer) trial (NEJM 2018) demonstrated unexpectedly that minimally invasive radical hysterectomy (laparoscopic or robot-assisted) had a significantly lower disease-free survival (91.2% vs. 97.1% at 4.5 years) and lower overall survival compared to open surgery for Stage IA1–IB1 cervical cancer. This landmark negative trial reversed the trend toward minimally invasive surgery for cervical cancer and led to current recommendations that open radical hysterectomy remains the standard of care.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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