Introduction/Background The LACC trial (Ramirez P, NEJM 2018; 379:1895–1904) and the Melamed report (Melamed A, NEJM 2018; 379:1905–1914) raise the question whether minimally invasive surgery (conventional and robot-assisted laparoscopy) is inferior to open abdominal surgery in early stage cervical cancer. Notable was the low rate of recurrence and death in the laparotomy group of the LACC trial. The current study investigates the results of patients with FIGO stage I cervical cancer treated with robot-assisted radical hysterectomy in hospitals of the Belgium and Luxembourg Gynaecological Oncology Group (BGOG).

Methodology In this prospective follow up study combined data of different BGOG hospitals were analysed of patients with stage IA1, IA2 and IB1 cervical cancer with a histologic subtype of squamous-cell carcinoma, adenocarcinoma or adenosquamous carcinoma treated with robot-assisted laparoscopy. Inclusion criteria were the same as in the LACC trial. Outcomes were disease free and overall survival at 3 years.

Results A total of 177 patients were eligible for analysis. Mean age was 46 years. Most patients had FIGO stage IB1 (84.2%) and squamous cell carcinoma as histological subtype (71,2%). Mean follow up time was 3,5 years, with a range from 0 to 131 months. 22 recurrences and 12 deaths were noted, of which 8 deaths were related to cervical cancer. Disease free survival at 3 years was 85%. Overall survival at 3 years was 96%.

Conclusion Current results in Belgium show disease free and overall survival rates of patients with early stage cervical cancer after robot-assisted laparoscopy that are consistent with those mentioned by the American and Canadian Cancer Society and earlier reports, except for the LACC trial and the Melamed report.

New randomized trials are needed to investigate whether minimally invasive surgery remains an equal option in the treatment of early stage cervical cancer in comparison to laparotomy.

Disclosure Nothing to disclose.