Comparison of Survival Outcomes between Minimally Invasive Surgery and Open Radical Hysterectomy in Early-Stage Cervical Cancer

SIMPLE SUMMARY: Radical hysterectomy is one of the most crucial treatments for early-stage cervical cancer. However, which surgical approach is better, either minimally invasive surgery (MIS) or laparotomy, is still debatable. This study showed comparative survival outcomes between MIS and laparotomy radical hysterectomy and provided some viewpoints on selected cases. Subgroup analyses showed favorable survival outcomes in patients who received robotic-assisted surgery and had pathologic tumor size ≤ 2cm. With advancements in surgical technologies and comprehensions of pelvic anatomy regarding to the parametrium and the paracolpium, MIS has gradually become an alternative for early-stage cervical cancer. Moreover, for patients with tumor size > 2cm, laparotomy radical hysterectomy showed good radicality in the resection of parametrium. We concluded that precise clinical evaluations and tailored surgical approaches for patients with early-stage cervical cancer were of great significance. ABSTRACT: Objectives: To compare the survival outcomes between minimally invasive surgery (MIS) and laparotomy radical hysterectomy in patients with early-stage cervical cancer. Methods: We conducted a retrospective study involving women who received a radical hysterectomy for cervical cancer, stage IA1 with lymphovascular invasion, IA2, IB1, IB2, or IIA from 2008 to 2016. Clinicopathologic and perioperative outcomes were compared using appropriate statistical methodologies. Results: Oncologic survival outcomes were analyzed using the Kaplan–Meier method. Among the 105 cases identified, 58 (55.2%) and 47 (44.8%) women underwent MIS and open radical hysterectomy, respectively. Over a median follow-up period of 62 months, women who underwent MIS and open radical hysterectomy had a 5-year overall survival rate of 87.9% and 89.4% (p = 0.845) and a 5-year disease-free survival rate of 82.5% and 86.7% (p = 0.624), respectively. Conclusions: For early-stage cervical cancer, patients who underwent MIS radical hysterectomy had survival outcomes that were comparable to those who underwent open surgery at our institute.