Patients undergoing minimally invasive surgery for cervical cancer are at a higher risk of recurrence and death, two studies from the MD Anderson Cancer Center in Houston suggest.
Results from the studies, published this week in the New England Journal of Medicine, prompted MD Anderson to stop offering minimally invasive radical hysterectomies for cervical cancer patients in March.
The first study, a clinical trial started in 2008, compared patients undergoing minimally invasive surgery to those receiving open surgery at 33 cancer centers in multiple countries. Originally designed to enroll 740 patients, the study was stopped in June of 2017 with 631 patients enrolled when it became apparent patients undergoing the minimally invasive procedure were faring worse.
The second study retrospectively compared data from the National Cancer Database and appears to confirm the clinical findings.
Researchers are conducting follow up studies to examine whether minimally invasive radical trachelectomy, a cervical cancer surgery similar to a hysterectomy meant to preserve a person's fertility, is also impacted.
Dr. Pedro Ramirez, a primary investigator on one of the studies, said the studies were not designed to examine why the minimally invasive procedure was associated with poorer survival. Ramirez theorized that the use of carbon dioxide gas in the surgery may influence the growth of cancer cells and that a tool used in the process may move cancer cells to new locations.
Ramirez called the response to the publication "overwhelming," adding that early results presented at the 2018 Society of Gynecologic Oncology Annual Meeting in April surprised many researchers. He encouraged patients who had or were considering the minimally invasive surgeries to speak with their doctors.