Keyhole surgery in cervical cancer carries higher risk of death than open surgery

MedTech News: Minimally invasive techniques are increasingly common in cancer surgery. A recent trial has brought into question the safety of minimally invasive radical hysterectomy for cervical cancer.

In this systematic review and meta-analysis, researchers analysed the data from 15 previous studies, including a total of 9,499 patients, and say minimally-invasive ‘keyhole’ hysterectomies were associated with an increased risk of death among women with cervical cancer, compared with open surgery.

Women who underwent the keyhole procedure died sooner than those who underwent open surgery, and the disease was more likely to return, say the authors.

The pooled hazard of recurrence or death was 71% higher among patients who underwent minimally invasive radical hysterectomy compared with those who underwent open surgery (hazard ratio [HR], 1.71; 95% CI, 1.36-2.15; P < .001), and the hazard of death was 56% higher (HR, 1.56; 95% CI, 1.16-2.11; P = .004). 

According to the authors, no association was found between the prevalence of robot-assisted surgery and the magnitude of association between minimally invasive radical hysterectomy and hazard of recurrence or death.

The findings support the survival benefits of undergoing full, open hysterectomy for early-stage cervical cancer.

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