In early-stage cervical cancer in patients with usual-type adenocarcinoma and adenosquamous carcinoma, researchers aimed to evaluate the survival benefits of minimally invasive surgery (MIS) versus open surgery for radical hysterectomy (RH). Patients with 2009 FIGO stage IB1-IB2 cervical cancer who underwent RH between 2007 and 2020 were retrospectively identified from the cervical cancer cohorts of 2 hospitals. After a pathological assessment conforming to the most recent World Health Organization Classification of Tumors, patients diagnosed with adenocarcinoma and adenosquamous carcinoma were included in the analysis. Survival rates and other clinicopathologic features were compared between patients who underwent open vs. minimally invasive surgery. There were 161 people that participated in this study. No significant differences were noted in overall survival (OS; P=0.241) and disease-free survival (DFS; P=0.156) between patients with usual-type adenocarcinoma (n=136) and those with adenosquamous carcinoma (n=25). MIS RH group (n=99) had a significantly smaller tumor size (P<0.001), lesser pathologic parametrial invasion (P=0.001), and lesser lymph node metastasis (P<0.001) than the open RH group (n=62). MIS and open RH groups showed similar OS (P=0.201) and 3-year DFS rates (87.9% vs. 75.1%; P=0.184). In multivariate analysis, worse DFS was not associated with MIS (P = 0.589) but was associated with pathologic parametrial invasion (adjusted HR, 3.41; 95% CI, 1.25–9.29; P = 0.016). The findings were consistent among patients with standard-type adenocarcinoma: MIS was not related to poorer DFS. In early-stage cervical usual-type adenocarcinoma and adenosquamous carcinoma, survival rates were similar for those who underwent MIS versus those who underwent open RH. Pathologic parametrial invasion was substantially linked with worse DFS in cervical usual-type adenocarcinoma and adenosquamous carcinoma, but minimally invasive surgery RH was not a bad prognostic factor.
Source: sciencedirect.com/science/article/pii/S0090825822005418
