Minimally invasive hysterectomy for stage IA cervical carcinoma: a survival analysis of the National Cancer database

Objectives: Evaluate the short-term and oncologic outcomes of minimally invasive surgery (MIS) for patients with stage IA cervical carcinoma undergoing simple or radical hysterectomy. Methods: Patients diagnosed between 2010 and 2015 with pathological stage IA squamous, adenocarcinoma, adenosquamous carcinoma of the cervix, who had no history of another tumor, underwent radical or simple hysterectomy with known mode of surgery, and had at least one month of follow-up were identified in the National Cancer Database. Comparisons of demographic and clinico-pathological characteristics were made with the chi-square test. The impact of MIS (robotic-assisted or traditional laparoscopy) on overall survival (OS) was assessed with the log-rank test following generation of Kaplan-Meier curves. A multivariate Cox model was constructed to control for confounders. Results: A total of 1930 patients who met the inclusion criteria were identified; the majority (73.3%, 1414 patients) had stage IA1 disease, while 458 (23.7%) patients had stage IA2 and 58 (3%) patients had stage IA not otherwise specified. A total of 1238 (64.1%) patients had simple hysterectomy, while 692 (35.9%) patients had radical hysterectomy. Rate of radical hysterectomy was higher among patients with stage IA2 disease compared to IA1 disease (53.3% vs 30.4%, p 0.05. Patients who had MIS had shorter hospital stay (median 1 vs 3 days, p Conclusions: In a large cohort of patients with pathological stage IA cervical carcinoma, performance of minimally-invasive hysterectomy was not associated with a detrimental effect on overall survival.