Cervical cancer || Disease-free survival of minimally invasive root-and-glycation hysterectomy

A multi-agency retrospective series of studies reported by uppal at the University of Michigan in the United States showed that patients who received minimally invasive root-and-glycation hysterectomy,including a final pathologically determined tumor of ≤ 2 cm, had poor disease-free survival (DFS), but had better overall survival rates across the queue.
(J Clin Oncol. 2020 doi:10.1200/JCO.19.03012.) This study aims to compare DFS between open and minimally invasive RH conducted in academic institutions.
From 1 January 2010 to 31 December 2017, the retrospective multi-agency study reviewed RH patients with stage I.A1 (with lymphatic tube immersion), I.A2 and I.B1 squamous, adenocarcinoma, or adenocarcinoma.
of 815 patients, 255 (29.1%) were in the open RH group and 560 (70.9%) were in the minimally invasive RH group.
there were 19 relapses (7.5%) in the open RH group and 51 relapses (9.1%) in the minimally invasive group (P-0.43).
analysis after risk correction showed that minimally invasive RH was independently associated with an increased risk of recurrence (HR=1.88, 95% CI 1.04-3.25).
factors associated with an increased risk of recurrence include tumor size, disease level, and assisted radiotherapy.
preoperative cone cutting was associated with a lower risk of recurrence (HR=0.4,95% CI 0.23-0.71).
there was no difference between the two groups of OS after unreconscioned analysis (HR=1.14,95% CI 0.61-2.11) or after correction of risk (HR=1.01,95% CI 0.5-2.2).
In 264 patients with a final pathological diagnosis of ≤ 2 cm (excluding patients with no residual tumors in the final pathology), the recurrence rate of the open RH group was 2.4% (2/82), while the recurrence rate of the minimally invasive RH group was 8.8% (16/182, P=0.058).
in the tendentid score matching analysis, the recurrence rate of the open RH group was 4.4 percent (7/159), while that of the minimally invasive RH group was 11.5 percent (18/156, P-0.019).
survival analysis showed an increased risk of recurrence of the minimally invasive group in the tendential matching queue (HR=2.83, 95 %CI 1.1-7.18).
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