As shown by the Laparoscopic Approach to Cervical Cancer (LACC) trial, early-stage cervical carcinoma patients who undergo a minimally invasive (MIS) radical hysterectomy have poorer oncologic outcomes and a lower risk of progression-free survival (PFS) and overall survival (OS) compared to those who undergo an open radical hysterectomy. Researchers aimed to compare the oncologic outcomes of MIS radical hysterectomy and OPEN radical hysterectomy at several centers. Patients diagnosed between January 2007 and December 2016 with cervical cancer stages IA1 (with lymphovascular space invasion) and IB1 were included in this retrospective cohort study that involved many institutions. Pre-treatment patients were not included. All types of squamous cell, adeno, and adenosquamous carcinomas were accounted for. Suitable statistical tests were employed. Investigators found 1,093 cases worthy of investigation, including 715 MIS (558 robotic [78%]) and 378. OPEN processes. Patients with tumors larger than 2 cm in the OPEN group were more likely to have taken adjuvant therapy, and there was higher evidence of disease in the hysterectomy specimen. The MIS group had a median follow-up of 38.5 months (range: 0.03-149.51), whereas the OPEN group had a median follow-up of 54.98 months (range: 0.03-145.20). There was no significant difference between the 3-year PFS rates of 87.9% (95% CI: 84.9-90.4%) and 89% (95% CI: 84.9-92%; P=0.6) between the 2 groups. According to the results of the multivariate analysis, the adjusted HR for recurrence/death was 0.70 (95% CI, 0.47-1.03; P=0.07). Rates of survival after 3 years were 95.8% (95% CI: 93.6-97.2%) and 96.6% (95% CI: 93.8-98.2%), respectively (P=0.8). A multivariate analysis found an adjusted hazard ratio (HR) for the death of 0.81 (95% CI, 0.43-1.52; P=0.5). This large-scale study found no difference in PFS or OS between MIS and OPEN radical hysterectomy for cervical cancer treatment.
Source: sciencedirect.com/science/article/pii/S0090825822004346
