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Two New Studies Warn Against Minimally Invasive Surgery for Cervical Cancer

Posted on November 01, 2018


The New England Journal of Medicine published two studies Wednesday that could deal a blow to minimally invasive surgery for Cervical Cancer. 

In the first studya total of 319 patients were assigned to minimally invasive surgery and 312 to open surgery. Of the patients who were assigned to and underwent minimally invasive surgery, 84.4% underwent laparoscopy and 15.6% robot-assisted surgery. When reviewing the results, minimally invasive radical hysterectomy was associated with lower rates of disease-free survival and overall survival than open abdominal radical hysterectomy among women with early-stage cervical cancer. 

The second study provided similar results as they performed a cohort study involving women who underwent radical hysterectomy for stage IA2 or IB1 cervical cancer during the 2010–2013 period at Commission on Cancer–accredited hospitals in the United States. In the primary analysis, 1225 of 2461 women (49.8%) underwent minimally invasive surgery. When reviewing the epidemiologic study, minimally invasive radical hysterectomy was associated with shorter overall survival than open surgery among women with stage IA2 or IB1 cervical carcinoma. 

What does this mean?

 In an editorial that accompanied the studies, Dr. Amanda N. Fader, director of the Kelly Gynecologic-Oncology Service at Johns Hopkins University, said the results had “dealt a great blow” to the minimally invasive surgical method for cervical cancer. Johns Hopkins has also halted these minimally invasive procedures, reverting to open surgery “for the time being,” she said.

As it should, these two studies should give physicians pause in recommending minimally invasive surgery for Cervical Cancer in these patient subsets. 

One way to track this would be to keep an eye on worldwide procedure data when Intuitive Surgical releases earnings as they breakout procedure volume and trends in each surgical category.