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Debate 42B - Is there a Role for Minimally Invasive Radical Hysterectomy for Management of Cervical Cancer?

No

from Section V - Cervical Cancer

Published online by Cambridge University Press:  20 July 2023

Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
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Summary

The results of the LACC trial, along with numerous observational studies, demonstrating worse disease-free survival and overall survival when performing minimally invasive radical hysterectomy have led NCCN, ESGO, ESMO, and FIGO guidelines to support the open approach when performing radical hysterectomy for early cervical cancer. Some have suggested avoiding use of uterine manipulator or performing vaginal protective maneuvers to avoid tumor spillage; however, these recommendations are based on retrospective observations in studies where evaluation of those factors was not the primary objective nor were they powered to answer such questions. Until further evidence, open radical hysterectomy should be the standard of care.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2023

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References

Ramirez, PT, et al. Minimally invasive versus abdominal radical hysterectomy for cervical cancer. N Engl J Med 2018;379:1895–1904.CrossRefGoogle ScholarPubMed
Melamed, A, et al. Survival after minimally invasive radical hysterectomy for early-stage cervical cancer. N Engl J Med 2018;379:19051914.CrossRefGoogle ScholarPubMed
Obermair, A, et al. Incidence of adverse events in minimally invasive vs open radical hysterectomy in early cervical cancer: results of a randomized controlled trial. Am J Obstet Gynecol 2020;222:249.e1–249.e10CrossRefGoogle ScholarPubMed
Frumovitz, M, et al. Quality of life in patients with cervical cancer after open versus minimally invasive radical hysterectomy (LACC): a secondary outcome of a multicentre, randomised, open-label, phase 3, non-inferiority trial. Lancet Oncol 2020;21:851860.CrossRefGoogle ScholarPubMed
Nitecki, R, et al. Survival after minimally invasive vs open radical hysterectomy for early-stage cervical cancer: a systematic review and meta-analysis. JAMA Oncol 2020;6:10191027. https://doi.org/10.1001/jamaoncol.2020.1694CrossRefGoogle ScholarPubMed

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