Minimally invasive techniques for cancer surgery are becoming increasingly common, but recent evidence questions the safety of minimally invasive radical hysterectomy for cervical cancer. The objective of this study is to determine the risk of recurrence and death in patients with early-stage cervical cancer who have received minimally invasive or open radical hysterectomy.
This is a systematic review and meta-analysis of observational studies from the datasets of PubMed, Scopus, Web of Science, Ovid Embase, and Ovid MEDLINE. This meta-analysis included a total of 15 studies comprising 9,499 patients who underwent a radical hysterectomy. 49.0% of the patients (n=4,684) received minimally invasive radical hysterectomy and 51.0% (n=4,815) received radical hysterectomy. Among the participants who received minimally invasive radical hysterectomy, 57% (n=2,675) of them received robot-assisted laparoscopy. The primary outcome was the risk of recurrence and death.
Out of 2,675 patients who received robot-assisted laparoscopy, 530 recurrences, and 451 deaths were reported. Compared to the patients who underwent open surgery, the hazard of recurrence and death was 71% higher in those who received minimally-invasive radical hysterectomy.
The research concluded that patients of early-stage cervical undergoing minimally invasive radical hysterectomy were at a higher risk of recurrence and death compared to open radical hysterectomy.