Objectives The adverse effect of laparoscopic/robotic surgery in cervical cancer has been established, however the exact patient population that this applies to has not been fully elucidated. Our objective was to characterize the impact of surgical approach on outcomes in cases of no residual cervical cancer on hysterectomy specimen.
Methods Retrospective cohort study of cases of surgically treated cervical cancer at 10 Canadian institutions from 2007–2019. Cases with no residual disease on hysterectomy specimen were included and subdivided according to: minimally invasive (MIS), abdominal (AH) or combined vaginal-laparoscopic hysterectomy (CVLH). Recurrence free survival (RFS) and overall survival (OS) were estimated using Kaplan-Meier analysis. Chi-square and log-rank tests were used to compare between cohorts.
Results Within the total cohort, 187/1070 (17.5%) had no residual disease on hysterectomy specimen. The distribution according to surgical approach was: 94 MIS, 78 AH, and 15 CVLH. The majority of cases undergoing MIS and AH were stage IB (51% and 60%), and underwent a radical hysterectomy (91% and 67%), whereas of CVLH patients, the majority were stage IA (93%) and underwent a simple hysterectomy (73%). There were no significant differences in RFS (5-year: MIS 96.0%, AH 90.7%, CVLH 100%, p=0.15) or OS (5-year: MIS 98.4%, AH 93.0%, CVLH 100%, p=0.067), although event-rates were low, and regression analysis was not performed.
Conclusions In this study of impact of surgical approach in cases with no residual cervical cancer on hysterectomy specimen, significant differences in RFS and OS among the surgical subgroups was not found. Further studies are warranted.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.