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Review
. 2022 Sep 15;19(18):11641.
doi: 10.3390/ijerph191811641.

Radical Hysterectomy for Early Stage Cervical Cancer

Giorgio Bogani  1 , Violante Di Donato  1 , Giovanni Scambia  2 , Francesco Raspagliesi  3 , Vito Chiantera  4 , Giulio Sozzi  4 , Tullio Golia D'Augè  1 , Ludovico Muzii  1 , Pierluigi Benedetti Panici  1 , Ottavia D'Oria  1 , Enrico Vizza  5 , Andrea Giannini  1 , On Behalf Of The Investigators Of The Italian Gynecological Cancer Study Group
Affiliations
Review

Radical Hysterectomy for Early Stage Cervical Cancer

Giorgio Bogani et al. Int J Environ Res Public Health. .

Abstract

Radical hysterectomy and plus pelvic node dissection are the primary methods of treatment for patients with early stage cervical cancer. During the last decade, growing evidence has supported the adoption of a minimally invasive approach. Retrospective data suggested that minimally invasive surgery improves perioperative outcomes, without neglecting long-term oncologic outcomes. In 2018, the guidelines from the European Society of Gynaecological Oncology stated that a "minimally invasive approach is favored" in comparison with open surgery. However, the phase III, randomized Laparoscopic Approach to Cervical Cancer (LACC) trial questioned the safety of the minimally invasive approach. The LACC trial highlighted that the execution of minimally invasive radical hysterectomy correlates with an increased risk of recurrence and death. After its publication, other retrospective studies investigated this issue, with differing results. Recent evidence suggested that robotic-assisted surgery is not associated with an increased risk of worse oncologic outcomes. The phase III randomized Robotic-assisted Approach to Cervical Cancer (RACC) and the Robotic Versus Open Hysterectomy Surgery in Cervix Cancer (ROCC) trials will clarify the pros and cons of performing a robotic-assisted radical hysterectomy (with tumor containment before colpotomy) in early stage cervical cancer.

Keywords: LACC; cervical cancer; laparoscopy; radical hysterectomy; robotic.

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Conflict of interest statement

The authors declare no conflict of interest.

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