More deaths seen for less invasive cervical cancer surgery

New evidence about a cancer operation in women finds a higher death rate for the less invasive version, challenging standard practice and the “less is more” approach to treating cervical cancer.

The unexpected findings are prompting changes at some hospitals that perform radical hysterectomies for early-stage disease.

The more rigorous of the two studies was conducted at more than 30 sites in a dozen countries.

It found women who had the less invasive surgery were four times more likely to see their cancer return compared to women who had traditional surgery.

Death from cervical cancer occurred in 14 of 319 patients who had minimally invasive surgery and 2 of 312 patients who had open surgery.

Results were published online Wednesday by the New England Journal of Medicine.

Radical hysterectomy is standard treatment for women with early-stage cervical cancer.

Rates are declining because of widespread screening.

The number of operations has fallen, too, to several thousand a year in the United States.

Some women with early-stage cervical cancer are choosing fertility-sparing techniques, treatments not included in the new research.

In both studies, researchers compared two methods for radical hysterectomy, an operation to remove the uterus, cervix and part of the vagina.

The surgery costs around $9,000 to $12,000 with the minimally invasive version at the higher end.

Traditional surgery involves a cut in the lower abdomen.

In a newer method, a surgeon makes small incisions for a camera and instruments. Patients recover faster, so laparoscopic surgery, which has been around for more than a decade, gained popularity despite a lack of rigorous long-term studies.

It’s not clear why it failed to measure up. 

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