The LACC trial (Lancet Oncology 2018) changed practice for early-stage cervical cancer by demonstrating that compared to open radical hysterectomy, minimally invasive radical hysterectomy was associated with:
- A Equivalent disease-free survival and lower complication rates
- B Higher disease-free survival in node-negative patients only
- C Significantly lower disease-free survival and higher recurrence rates ✓
- D Similar oncologic outcomes but significantly shorter hospital stay
Correct answer: C. Significantly lower disease-free survival and higher recurrence rates
Explanation
The LACC (Laparoscopic Approach to Cervical Cancer) trial enrolled women with Stage IA1 (with LVSI), IA2, or IB1 cervical cancer and found that minimally invasive radical hysterectomy (laparoscopic or robot-assisted) was associated with significantly lower disease-free survival (3-year DFS: 91.2% vs 97.1%) and higher recurrence/death rates compared to open radical hysterectomy. This landmark trial led to a shift back toward open surgery as the standard of care for radical hysterectomy in cervical cancer.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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Written and medically reviewed by the StethoPrep medical team.