- OS was significantly shorter with minimally invasive surgery (MIS) vs open surgery in women with stage IA2/IB1 cervical cancer undergoing radical hysterectomy.
- Adoption of MIS in the United States coincided with the decline in survival rates starting 2006.
Why this matters
- The findings differ from general consensus within the field of gynecologic oncology that supports MIS in early-stage cervical cancer.
- Study of 2461 women with stage IA2/IB1 cervical cancer from National Cancer Database who underwent radical hysterectomy during 2010-2013.
- Funding: National Cancer Institute; National Institute of Child Health and Human Development; others.
- 49.8% of women underwent MIS.
- Median follow-up, 45 months.
- Women who underwent MIS showed significantly worse 4-year OS vs those who underwent open surgery (HR, 1.65; P=.002).
- In the MIS vs open-surgery group:
- mean numbers of lymph nodes evaluated were 20.2 vs 19.2.
- parametrial invasion rates were 11.0% vs 9.5%.
- positive margin rates were 5.0% vs 4.4%.
- lymph-node involvement rates were 10.7% vs 8.9%.
- lymphovascular space invasion rates were 31.9% vs 28.0%.
- MIS adoption coincided with the beginning of a decline in 4-year relative survival 0.8% (Ptrend=.01) per year.
- Information on recurrence and cause of death was not available.
- Observational design.