Survival outcomes of minimally invasive versus open radical hysterectomy in patients with early-stage IB1 to IIA2 cervical cancer: A single-center retrospective study

This study aimed to investigate the survival outcomes and prognostic factors associated with the surgical approach in patients with early-stage cervical cancer. We retrospectively analyzed 245 patients with stage IB1 to IIA2 cervical cancer who underwent radical hysterectomy with pelvic lymphadenectomy between 2004 and 2019 at Dong-A University Hospital. A total of 59 patients underwent minimally invasive surgery (MIS), and 186 patients underwent open surgery. There were no significant differences between the 2 groups, except for stromal invasion (P < .001), lymphovascular invasion (P = .001), and requirement for adjuvant therapy (P < .001). There were no significant differences in disease-free survival (DFS) and overall survival (OS) based on the surgical approach. However, multivariate analyses showed MIS was an independent poor prognostic factor of DFS (adjusted hazard ratio [HR]: 230; 95% confidence interval [CI]: 086–0.614, P = .003) and OS (adjusted HR: 135; 95% CI: 041–0.451, P = .001). Adjuvant therapy was a poor prognostic factor for DFS (adjusted HR: 6.546; 95% CI: 1.384–30.952; P = .018), and deep stromal invasion was a poor prognostic factor for OS (adjusted HR: 8.715; 95% CI: 1.636–46.429; P = .01). MIS may be an independent poor prognostic factor for DFS and OS in patients who undergo radical hysterectomy for early-stage cervical cancer.