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Comparison of open and minimally invasive radical hysterectomy for cervical cancer: a systematic review and meta-analysis of survival outcomes.
This systematic review and meta-analysis compared open radical hysterectomy (ORH) with minimally invasive surgery (MIS) for cervical cancer using studies…
Signal score70Research triage score
CertaintyModerateVerify in full text
PMID42249382Source identifier
Research triage, not medical advice
Do not use this summary, score, or benefit-cost estimate to diagnose, treat, prescribe, or change care without reviewing the full study and consulting qualified professionals.
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Plain-English signal
This systematic review and meta-analysis compared open radical hysterectomy (ORH) with minimally invasive surgery (MIS) for cervical cancer using studies from the last 10 years. According to the abstract, patients who had open surgery had better 5-year disease-free survival than those who had minimally invasive procedures. However, overall survival did not differ significantly between the two approaches in subgroup analyses by tumor size (≤2 cm and >2 cm). The report is based on pooled results from observational studies; full-text review is needed to confirm methods, absolute risks, and applicability to specific patients.
Why it matters
- Addresses a clinically important choice of surgical approach (open radical hysterectomy vs minimally invasive surgery) for cervical cancer, which may affect recurrence (disease-free survival) and overall survival.
- Finds a difference in 5-year disease-free survival favoring open surgery, which could influence surgical decision-making, guideline updates, or shared decision discussions for patients with cervical cancer.
- Includes subgroup analysis by tumor size (≤2 cm vs >2 cm), which is a relevant stratifier for operative planning and risk discussion.
Primary outcomes
- 5-year disease-free survival
- Overall survival (subgroup by tumor size ≤2 cm vs >2 cm)
Effect summary
Abstract-reported pooled results from 15 clinical studies: open radical hysterectomy was associated with improved 5-year disease-free survival compared with minimally invasive surgery (OR = 1.70 [1.27, 2.27]). Subgroup analyses showed no significant differences in overall survival between ORH and MIS for tumor size ≤2 cm (HR = 1.10 [0.28, 4.31]) or >2 cm (HR = 0.82 [0.38, 1.77]).
Benefit-cost lens
| Quick take | Abstract-level meta-analysis suggests open radical hysterectomy (ORH) is associated with better 5-year disease-free survival than minimally invasive surgery (MIS), while overall survival did not differ in available subgroup analyses. Economic or implementation implications are unclear without absolute risks, costs, and population counts. |
|---|---|
| BCR anchor | 2 |
| Time horizon | 3 |
| Discount rate | 0.03 |
| Assumptions | Based only on PubMed metadata and abstract; assumes extracted effect measures are pooled odds ratio for 5-year DFS and hazard ratios for OS as reported in abstract. Full text may change effect estimates, inclusion criteria, and risk-of-bias judgments. |
Benefit-cost fields are assumptions-based unless explicitly source-derived. Treat them as prompts for deeper economic review.
Risk of bias
| Tool | Abstract-limited ROB assessment (NOS reported for observational studies) |
|---|---|
| Verdict | Some concerns |
| Notes | Assessment based only on abstract: included studies were observational and scored ≥7 on Newcastle-Ottawa Scale per abstract, but details on covariate adjustment, consistency, publication bias, and pooled-analysis methods are not available. Full-text ROBIS/ROBINS-I and assessment of heterogeneity are needed. |
Harms, equity, conflicts & implementation
| Implementation | Full-text review; extraction of absolute event rates and adjusted effect estimates; assessment of surgical volumes, training, equipment costs, OR time, length of stay differences, and local baseline recurrence rates; stakeholder consultation (surgeons, oncology, patients). |
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| Equity impact | Unclear from abstract. Potential equity implications if access to ORH versus MIS differs by geography, socioeconomic status, or health system resources; full text should report subgroup access and demographic data. |
| Harms | Abstract does not report harms, complications, perioperative morbidity, or quality-of-life outcomes; these must be extracted from full text before weighing tradeoffs between approaches. |
| Replication | Unknown from automated PubMed triage; replication would require accessing full-text analyses and included primary studies. |
Source links — verify original
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