Minimally Invasive Surgery for Cervical Cancer

Surgery is the standard treatment for early stage cervical cancer. Over the last few decades, growing evidence has supported the adoption of minimally invasive radical hysterectomy for the treatment of patients with surgical indications. Retrospective data suggested that minimally invasive surgery (MIS) improved perioperative outcomes without affecting oncologic outcomes until the unexpected results of the phase III randomized Laparoscopic Approach to Cervical Cancer (LACC) trial revealed that, compared with the open abdominal approach, MIS correlated with worse disease-free and cancer-specific survival. Other retrospective studies corroborated this result. In this chapter, we assess the current status and unresolved issues around MIS in patients with early stage cervical cancer. We conclude that minimally invasive surgery should be offered in the context of clinical trials with detailed informed consent, and that ongoing trials with well-designed protocols may improve the status of early stage cervical cancer treatment.