Researchers find survival improves with open radical hysterectomy in early-stage cancer

Early-stage cervical cancer patients see better survival and decreased recurrence rates after open radical hysterectomy than minimally invasive laparoscopic approaches, according to a five-year study led by Houston Methodist researchers and published in the Journal of Clinical Oncology.

"The findings from this and an initial study in 2018 led to the change in the National Comprehensive Cancer Network guidelines established that same year that for radical hysterectomy we routinely perform an open approach. This latest study reaffirms this recommendation," said Pedro T. Ramirez, M.D., chair of the Department of Obstetrics and Gynecology at Houston Methodist.

Cervical cancer is a growth of cells that starts in the cervix in the lower part of the uterus. Women between the ages of 35 and 44 are most frequently diagnosed with cervical cancer. In its early stages, the disease is curable by removing the cancerous tissue. In other cases, a hysterectomy may be required.

This newly published research builds on the findings of the 2018 study which found minimally invasive surgery for early-stage cancer carries a higher risk of the disease returning and causing death. Ramirez led the 2018 study along with the new study titled, "LACC Trial: Final Analysis on Overall Survival Comparing Open Versus Minimally Invasive Radical Hysterectomy for Early-Stage Cervical Cancer."

Ramirez and his collaborators from across the world found the rate of survival at four and a half years is 90.6% for minimally invasive surgery, compared to 96.2% for open surgery. Approximately 85% of patients who underwent minimally invasive surgery remained cancer free versus 96% of patients who remained cancer free after open surgery.

"We have a few theories on why outcomes are better with open surgery, including innate risks of expanding the abdomen with gas during the procedure, or using specific medical devices that could increase the likelihood of tumor cells spreading. We have more research underway to try and pinpoint a cause," said Ramirez.