The following is a summary of “Ten-year outcomes following laparoscopic and open abdominal radical hysterectomy for “low-risk” early-stage cervical cancer: A propensity-score based analysis,” published in the July 2023 issue of Gynecologic Oncology by Donato et al.

Accumulating evidence suggested that implementing minimally invasive surgery to treat cervical cancer in its early stages would be detrimental. However, there is evidence regarding the long-term effectiveness of minimally invasive radical hysterectomy in “low-risk” patients. This is a retrospective comparison between minimally invasive and open radical hysterectomies in early-stage cervical cancer patients with low risk. Patients were assigned to study groups using a propensity-score matching algorithm (1:2). The Kaplan-Meir model was utilized to estimate progression-free and overall survival at ten years.

About 224 “low-risk” patients’ medical records were retrieved. All 50 women undergoing radical hysterectomy and 100 undergoing open radical hysterectomy were matched. Minimally invasive radical hysterectomy was associated with a longer median operative time (224 (100–310) vs. 184 (150–240) minutes; p<0.001), lower estimated blood loss (10 (10-100) vs. 200 (100-1000) ml; P<0.001), and shorter hospital stay (3.8 (3-6) vs. 5.1 (4-12) days; P<0.001). The surgical approach did not affect the risk of intra-operative (4% vs. 1%; P = 0.257) or 90-day severe (grade 3+) postoperative complications (4% vs. 8%; P = 0.497) complications. 

Survival without disease at ten years was comparable between groups (94% versus 95%; P = 0.812; HR:1.195; 95% CI:0.275, 5.18). Overall survival at ten years was similar between the two groups (98% vs. 96%; P = 0.995; HR:0.994; 95% CI:0.182, 5.424).

Emerging evidence suggests that laparoscopic radical hysterectomy does not result in worse 10-year outcomes for low-risk patients than the open approach. However, additional research is required, and radical abdominal hysterectomy remains the standard treatment for patients with cervical cancer.

Source: sciencedirect.com/science/article/abs/pii/S0090825823002093