Unexpected Outcome in Hysterectomy Study

Women undergoing radical hysterectomy for early cervical cancer had a significantly higher risk of disease recurrence and worse long-term survival with minimally invasive surgery (MIS), including robotic-assisted procedures, two separate studies showed.

The number of disease recurrences after laparoscopic or robotic-assisted procedures was almost four times higher than the number of recurrences after open surgery, although the absolute numbers were small: 27 recurrences versus seven in more than 600 patients. The difference translated into a hazard ratio for disease-free survival (DFS) of 3.74 (at 4.5 years) for MIS versus open surgery.

Significantly more patients who had conservative surgery died during a median follow-up of 2.5 years: 19 versus three with open surgery. Although the absolute numbers remained small, the difference meant that women who had MIS were six times as likely to die during the follow-up period, Pedro T. Ramirez, MD, of the University of Texas MD Anderson Cancer Center in Houston, reported here at the Society of Gynecologic Oncologyannual meeting.

“Disease-free survival at 4.5 years for minimally invasive radical hysterectomy was inferior compared to the open approach,” Ramirez said in conclusion. “Minimally invasive radical hysterectomy was associated with higher rates of locoregional recurrence. Results of [this] trial should be discussed with patients scheduled to undergo radical hysterectomy.”

Read more from MedPage Today, by Charles Bankhead, Unexpected Outcome in Hysterectomy Study.