Objective Explore the difference of oncology outcome of laparotomy and laparoscopy in the new FIGO2018 stage of early cervical squamous cell carcinoma without any high risk pathological factors. Methods The 5-years OS and DFS of cervical squamous cell carcinoma undergoing laparotomy and laparoscopy from 2004 to 2018 were compared by the total study population and propensity score from China. Result There was no difference in 5-year OS between laparotomy (2,478 cases) and laparoscopy (1,504 cases), but the 5-year DFS of laparotomy was higher (92.2 %vs. 90.4%, P=0.022). Cox analysis showed that laparoscopy was not an independent risk factor for the death of cervical squamous cell carcinoma (OS: P=0.598), but it was an independent risk factor for the recurrence/death (HR = 1.468,95% CI 1.131 ~ 1.906, P=0.004). There was no difference in 5-year OS between laparotomy (2,391 cases) and laparoscopy (1,495 cases) after 1:2 PSM, but the 5-year DFS of laparotomy was higher (92.7% vs. 90.8%, P = 0.006), Cox analysis showed that laparoscopy was not an independent risk factor for the death of cervical squamous cell carcinoma (OS： P=0.521), but it was an independent risk factor for the recurrence/death (HR=1.512, 95%CI 1.151~1.971, P=0.002). Conclusion There is no difference in 5-year OS between these groups for early cervical squamous cell carcinoma in new stage of FIGO2018 without any high-risk pathological factors, the 5-year DFS of laparotomy is higher than that of laparoscopy group, and laparoscopy is an independent risk factor for recurrence/death, so laparoscopy has a higher risk of recurrence.

Objective To compare long-term survival outcomes between laparoscopic radical hysterectomy (LRH) and open radical hysterectomy (ORH) in early-stage cervical adenocarcinoma under the new FIGO 2018 staging guideline. Design Retrospective study Setting and population Early-stage cervical adenocarcinoma received LRH and ORH; 47 Chinese hospitals. Methods We matched patients with early-stage cervical adenocarcinoma in the new FIGO 2018 staging guideline with known risk factors for recurrence who underwent ORH and LRH. Main Outcome Measures 5-year overall survival and 5-year disease-free survival rates Results In total, 549 patients were enrolled in our study, including 235 patients in LRH group and 314 in ORH group. After matching some factors that may affect the prognosis, each group had 223 patients. There was no difference in DFS between LRH and ORH in risk-adjusted analysis (HR1.258, 95% CI: 0.507-3.125, P=0.621). There was no difference in OS between LRH and ORH in risk-adjusted analysis (HR1.961, 95% CI: 0.536-7.183, P=0.309). LRH resulted in significantly lower estimated blood loss (361.2 versus 165.3 ml, P < 0.001) and shorter postoperative anal exhaust time (2.8 versus 2.5 days, P = 0.003) . Intraoperative complication ( 2.7% versus 5.8%，P=0.101) and postoperative complication ( 5.8% versus 6.3%, P=0.843) rates were similar in the two groups. Conclusions LRH has comparable survival outcomes with ORH and was associated with earlier recovery in early-stage adenocarcinoma of the uterine cervix. LRH may be an appropriate option for early-stage cervical adenocarcinoma compared with ORH.