Photo Credit: Hulko

The following is a summary of “Oncological outcomes after vaginal and robotic-assisted radical trachelectomy in patients with cervical cancer – A single-center prospective cohort study,” published in the February 2025 issue of European Journal of Surgical Oncology by Soltanizadeh et al. 

This study aimed to compare the oncological outcomes of robotic-assisted radical trachelectomy (RART) and radical vaginal trachelectomy (RVT) in patients with localized early-stage cervical cancer, focusing on a national cohort in Denmark. Radical vaginal trachelectomy was first introduced in Denmark in 2003 and was centralized at Copenhagen University Hospital. In 2014, the procedure transitioned to a robotic-assisted approach, marked by the implementation of RART. Both procedures have been continuously documented in the Danish Gynecological Cancer Database (DGCD), which includes perioperative and oncological data. 

This prospective cohort study includes all patients undergoing radical trachelectomy and draws data from the DGCD, manually cross-referenced with the Danish Pathology Registry and electronic medical records to ensure accuracy. In total, 206 patients who underwent radical trachelectomy were included in the analysis, comprising 78 patients who underwent RART and 128 patients who received RVT. The study found no significant differences in the microscopic free margins of the trachelectomy specimens between the two groups, suggesting comparable surgical efficacy in terms of margin clearance. Of the patients who underwent RVT, seven (5.5%) experienced recurrence, compared to two (2.6%) of the RART group (p=0.403). Further analysis of recurrence-free survival showed no significant difference between the groups, both in the unadjusted (HR 0.51 [0.11-2.47]) and adjusted (HR 0.80 [0.16-3.96]) models, indicating that the recurrence rates were similar between the two approaches. 

These findings suggest that, in this large single-center cohort, RART and RVT offer comparable oncological safety for patients with localized cervical cancer, particularly for those seeking fertility preservation. As both procedures have demonstrated similar outcomes in terms of recurrence and survival, robotic-assisted surgery presents a viable alternative to the traditional vaginal approach without compromising oncological efficacy.

Source: ejso.com/article/S0748-7983(25)00099-X/fulltext