Minimally invasive, open radical hysterectomy yield similar survival outcomes in cervical cancer

Patients with early-stage cervical usual-type adenocarcinoma and adenosquamous carcinoma who undergo minimally invasive radical hysterectomy (RH) appear to have comparable survival outcomes as their counterparts who receive open RH, according to a study.

Researchers looked at two cervical cancer cohorts involving cervical cancer patients with 2009 FIGO stage IB1–IB2 who underwent RH. They identified 136 patients with usual-type adenocarcinoma and 25 with adenosquamous carcinoma for inclusion in the analysis.

Of the patients, 99 underwent minimally invasive surgery and 62 had an open surgery. These two groups were similar in terms of age (mean 47.8 vs 49.2 years) and the proportion of individuals with usual-type adenocarcinoma (88.9 percent vs 77.4 percent). However, significantly more patients in the minimally invasive group had 2009 FIGO stage IB1 disease (91.9 percent vs 77.4 percent) and received preoperative conization (37.4 percent vs 21.0 percent). 

Patients with usual-type adenocarcinoma and those with adenosquamous carcinoma had similar overall survival (OS; p=0.241) and disease-free survival (DFS; p=0.156).

Compared with the open surgery group, the minimally invasive surgery group had a significantly smaller tumour size, less pathologic parametrial invasion (p=0.001), and less lymph node metastasis (p<0.001). Meanwhile, survival outcomes were similar, including OS (p=0.201) and 3-year DFS rate (87.9 percent vs 75.1 percent; p=0.184).

In multivariate analysis, worse DFS was associated with pathologic parametrial invasion (adjusted hazard ratio, 3.41, 95 percent confidence interval, 1.25–9.29; p=0.016) but not with minimally invasive surgery. This result was consistent among patients with usual-type adenocarcinoma.