A Randomized Controlled Trial of Laparoscopic Radical Hysterectomy versus Open Radical Hysterectomy for Early-Stage Cervical Cancer: The 10-Year Follow-up

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 349–360

DOI: 10.46882/2026/IJOG/000506

Original Research Article

Title: A Randomized Controlled Trial of Laparoscopic Radical Hysterectomy versus Open Radical Hysterectomy for Early-Stage Cervical Cancer: The 10-Year Follow-up

Names of Authors: Olayinka O. Cole¹, Nesta C. Chuka¹

Authors’ Affiliations:
¹ Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, National Hospital, Abuja, Nigeria

Abstract:
Recent landmark trials have questioned the oncological safety of minimally invasive surgery for cervical cancer. This retrospective analysis presents the final 10-year long-term survival outcomes of a randomized clinical trial comparing Laparoscopic Radical Hysterectomy (LRH) to Open Radical Hysterectomy (ORH) in early-stage (Stage IA2 to IB1) cervical carcinoma. Long-term follow-up profiles of 150 patients randomized between 2014 and 2016 were analyzed: LRH (n = 75) and ORH (n = 75). The primary outcomes were 10-year disease-free survival (DFS) and overall survival (OS) rates. At 10 years, the DFS rate was significantly lower in the LRH group compared to the open surgical group (72.0% vs. 85.3%; Hazard Ratio [HR] = 1.94; 95% CI, 1.12 to 3.37; p = 0.016). The 10-year overall survival rate was also lower in the laparoscopic cohort (77.3% vs. 89.3%, p = 0.038). Locoregional pelvic recurrence occurred in 18.7% of LRH patients compared to 6.7% of open surgery patients (p = 0.024). Subgroup analysis indicated that the risk of recurrence was most pronounced in tumors exceeding 2 cm in diameter. Perioperative benefits (lower blood loss and shorter hospital stay) in the LRH group did not offset the long-term oncological deficit. In conclusion, long-term 10-year tracking confirms that laparoscopic radical hysterectomy is associated with significantly lower disease-free and overall survival rates compared to open abdominal radical hysterectomy in early-stage cervical cancer, confirming that the open approach remains the preferred standard.

Keywords: Cervical Cancer; Radical Hysterectomy; Laparoscopy; Open Laparotomy; Long-Term Survival; Disease Recurrence.

Manuscript Timeline: Received: May 22, 2026; Revised: July 12, 2026; Accepted: August 03, 2026; Published: August 15, 2026.

Citation: Cole OO, Chuka NC. A Randomized Controlled Trial of Laparoscopic Radical Hysterectomy versus Open Radical Hysterectomy for Early-Stage Cervical Cancer: The 10-Year Follow-up. International Journal of Obstetrics and Gynecology. 2026; 14(8): 349–360.

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