Effect of a Randomized, Controlled Trial on Surgery for Cervical Cancer

This study evaluated the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial, which demonstrated worse survival outcomes with minimally invasive radical hysterectomy compared to open surgery for early stage cervical cancer. Using data from the Premier Healthcare Database (November 2015–March 2020), researchers found a significant decline in minimally invasive hysterectomies post-trial publication (58.0% to 42.9%, P<0.001), with academic centers showing a sharper reduction (odds ratio: 0.27) than nonacademic centers (0.81). No change was observed in minimally invasive hysterectomies for benign conditions (e.g., uterine fibroids). The findings highlight how randomized trial data can rapidly alter clinical practice, though disparities in adoption persist across hospital settings.

This study evaluated the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial, which demonstrated worse survival outcomes with minimally invasive radical hysterectomy compared to open surgery for early stage cervical cancer. Using data from the Premier Healthcare Database (November 2015–March 2020), researchers found a significant decline in minimally invasive hysterectomies post-trial publication (58.0% to 42.9%, P<0.001), with academic centers showing a sharper reduction (odds ratio: 0.27) than nonacademic centers (0.81). No change was observed in minimally invasive hysterectomies for benign conditions (e.g., uterine fibroids). The findings highlight how randomized trial data can rapidly alter clinical practice, though disparities in adoption persist across hospital settings.