Minimally invasive vs open hysterectomy for the treatment of early cervical cancer retrospective population-based cancer registry study

Introduction Cervical cancer is the fourth most frequently cancer in women worldwide. Radical hysterectomy is the operative treatment of choice for early cervical cancer. Very recently, two studies raised serious doubt whether minimally invasive surgery (MIS) is as safe as open surgery.

Materials and methods With this large population-based cancer registry we aimed to compare the MIS and open radical surgery for early cervical cancer. We included 993 patients diagnosed between 2010 and 2015. After exclusion 413 patients were eligeble for analysis. DFS was the primary outcome.

Results The patients were divided into two groups: 111 in the MIS group and 302 in the open surgery group. The median follow-up time was 5.6 years. The rate of DFS was 89.2 % in the MIS and 72.2 % in the open group, respectively (p = 0.005). MIS was also associated with an improved OS. The OS in the MIS group was 93.7 %, whereas the OS in the open surgery group was 79.1 % (p = 0.013). After adjustment for other prognostic covariates, the MIS remained a favourable prognostic factor for DFS (hazard ratio (HR) 0.45, 95 % CI 0.24-0.86) but not for OS.

Conclusion In this population-based cancer registry study we demonstrated that both MIS and open surgery are safe methods to tread early cervical cancer. Notably, this data are in contrast tot he resent published LACC-trial, but are in agreement with two earlier meta-analyses. Further investigation of this topic is needed.

Publication History

Article published online:
07 October 2020