Loading
Keyhole surgery, assumed equivalent, turned out to be worse: more recurrences and more deaths than open surgery, reversing practice overnight.
4.5-year disease-free survival 86.0% vs 96.5% and OS HR for death 6.00 with minimally invasive surgery (NEJM 2018); the final analysis (2024) confirmed inferiority. Guidelines now recommend open radical hysterectomy; tumour spillage from uterine manipulators and CO2 is the leading hypothesis. Trials of protective manoeuvres (RACC, ROCC) are ongoing.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
636 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Disease-free survival at 4.5 yearsprimary | Minimally invasive | 319 | 86% | 3.74 (1.63 to 8.58) | - | link |
| Open surgery | 312 | 96.5% | ||||
| Overall survival at 3 years | Minimally invasive | - | 93.8% | 6 (1.77 to 20.3) | - | link |
| Open surgery | - | 99% |
Shares Cervical cancer and the tag failure.
Shares Pedro T. Ramirez, MD Anderson Cancer Center, Cervical cancer.
Shares Early cervical cancer and fertility-sparing surgery, Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Cervical cancer.
Shares Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Surgery and radiotherapy cure most, get least, Robotic & minimally invasive surgery.
Shares Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work, Surgery and radiotherapy cure most, get least.
Shares MD Anderson Cancer Center, Robotic & minimally invasive surgery.
Shares Surgery and radiotherapy cure most, get least, Cervical cancer.
Shares Surgery and radiotherapy cure most, get least, Robotic & minimally invasive surgery.