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Open Surgery May Reduce Recurrence Risk in Early-Stage Cervical Cancer

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Open Surgery May Reduce Recurrence Risk in Early-Stage Cervical Cancer

For women with early-stage cervical cancer, surgery is often the main treatment. Doctors can perform the surgery using either open surgery (a larger incision) or minimally invasive surgery (MIS), which includes robotic or laparoscopic techniques with smaller incisions. MIS is often preferred for faster recovery and less pain, but questions remain about whether it is as safe as open surgery for long-term cancer control.

A new study looked at more than 400 women treated for stage IA2 to IIA1 cervical cancer in Northern California between 2005 and 2018. The researchers compared outcomes between women who had MIS and those who had open surgery.

The results showed important differences:
– Women who had MIS were more likely to experience cancer recurrence than those who had open surgery (12% vs. 4%).
– After 10 years, recurrence-free survival was 87% with MIS versus 97% with open surgery.
– Even in women with small tumors (<2 cm), open surgery was linked to better survival and lower recurrence.
– For very early cancers (stage IA1), none of the women—regardless of surgery type—had cancer return.

The study also found that women who had a cone biopsy before surgery had a lower chance of recurrence.

These findings suggest that for stage IA2 to IIA1 cervical cancer, open surgery may provide better long-term cancer control than minimally invasive surgery, even for small tumors. For very early cancers (stage IA1), both surgical approaches remain safe.

Women facing surgical decisions should talk with their doctors about these findings, balancing recovery time with long-term survival outcomes.

DOI: 10.1016/j.ijgc.2025.101928

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