Radical Hysterectomy Registry

Update on 06/03/2019

Link to ASCO Slides:

DOWNLOAD ASCO SLIDES on the presentation on 06/03/2019

Read my opinion (along with my colleague Dr. Ryan Spencer) on the future of minimally Invasive Radical Hysterectomy published in the International Journal of Gynecological Cancer (IJGC)

Editorial Link

TRUST BUT VERIFY STUDY DETAILS

STUDY details:

Background

The National Comprehensive Cancer Network Guidelines (NCCN) recommends a radical hysterectomy for early-stage localized cervical cancer.1 Radical hysterectomy can be performed either using robotic or laparoscopic approach (minimally invasive radical hysterectomy) or using open abdominal approach (open radical hysterectomy). Several publications have compared the minimally invasive approach to the open radical hysterectomy and have concluded that the minimally invasive approach leads to improved postoperative outcomes (reduced estimated blood loss, lower transfusion rates, reduced length of stay after surgery and overall lower intra-operative complications).23 Furthermore, a meta-analysis of 17 clinical controlled trials concluded that specifically robotic radical hysterectomy was superior to both laparoscopic approach or open radical hysterectomy.4
Long-term survival between the minimally invasive and open approach has not been studied extensively. Few notable studies, which include a small retrospective review comparing 58 patients managed via robotic approach to 39 patients with an open approach. This study concluded that 5-year disease-free survival, as well as overall survival, were similar between the two approaches.5 Another study compared laparoscopic radical hysterectomy (n=263) to open approach (n=263) and reported similar 5-year recurrence-free survival (92.8% vs. 94.4%, p=0.5). 6

However, during the Society of Gynecologic Oncology (SGO), 2018 Annual Meeting of Women’s Cancer, there were two abstracts presented as late-breaking abstracts, with data to support that open radical hysterectomy had a survival advantage compared to the minimally invasive approach. Although these studies are not yet published, there is a potential that the results could lead to a change in clinical practice. While we await the publication of these studies, are conducting a retrospective review of long-term outcomes (disease-free survival and overall survival) patients undergoing radical hysterectomy as a definitive surgical management of early-stage cervical cancer.

Documents

Version 2:
Protocol August 2018 – IRB approved

Michigan IRB approval

Participating Sites

Site ID Site PI
1 University of Michigan Dr. Shitanshu Uppal
2 Ohio State University Dr. Kristin Bixel
3 Duke University Dr. Brittany Davis
4 University of North Carolina Dr. Paola Gehrig
5 Oklahoma University Dr. Laura Holman
6 University of Southern California Dr. Koji Matsuo
7 Florida Hospital Medical Group Dr. Robert Halloway
8 University of Wisconsin Dr. Steven Rose
9 University of Pittsburgh Medical Center Dr. Alex Olawaiyea

Enrollment in this retrospective study is now closed.


  1. Koh W-J, Greer BE, Abu-Rustum NR, et al. Cervical Cancer, Version 2.2015. J Natl Compr Canc Netw. 2015;13(4):395-404; quiz 404. ↩︎
  2. Sert BM, Boggess JF, Ahmad S, et al. Robot-assisted versus open radical hysterectomy: A multi-institutional experience for early-stage cervical cancer. Eur J Surg Oncol. 2016;42(4):513-522. ↩︎
  3. Ko EM, Muto MG, Berkowitz RS, Feltmate CM. Robotic versus open radical hysterectomy: a comparative study at a single institution. Gynecol Oncol. 2008;111(3):425-430. ↩︎
  4. Jin Y-M, Liu S-S, Chen J, Chen Y-N, Ren C-C. Robotic radical hysterectomy is superior to laparoscopic radical hysterectomy and open radical hysterectomy in the treatment of cervical cancer. PLoS One. 2018;13(3):e0193033. ↩︎
  5. Mendivil AA, Rettenmaier MA, Abaid LN, et al. Survival rate comparisons amongst cervical cancer patients treated with an open, robotic-assisted or laparoscopic radical hysterectomy: A five year experience. Surg Oncol. 2016;25(1):66-71. ↩︎
  6. Nam J-H, Park J-Y, Kim D-Y, Kim J-H, Kim Y-M, Kim Y-T. Laparoscopic versus open radical hysterectomy in early-stage cervical cancer: long-term survival outcomes in a matched cohort study. Ann Oncol. 2012;23(4):903-911. ↩︎