Minimally invasive surgery and abdominal radical hysterectomy in patients with early-stage cervical cancer: A meta-analysis

Objective To compare risk of recurrence and death related to minimally invasive surgery (MIS) and abdominal radical hysterectomy (ARH) in early-stage cervical cancer (CC) patients. Methods All relevant literatures in databases were retrieved from the built time of databases to October 2020. Observational studies comparing MIS and ARH in early-stage CC patients were involved. Newcastle-Ottawa Scale was used for quality assessment, including studies with a score of at least 6. Main outcomes involved overall survival (OS) and disease-free survival (DFS). Results Twenty-two studies were involved, including 14 894 patients, among which 7213 (48.6%) underwent MIS. The OS (hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.03-1.43) and DFS (HR 1.25, 95% CI 1.07-1.42) of patients undergoing MIS was obviously shortened compared with those of patients undergoing ARH. Subgroup analysis revealed that OS (HR 1.42, 95% CI 1.10-1.74) and DFS (HR 1.46, 95% CI 1.18-1.74) of patients with a tumor >= 2 cm in diameter were significantly reduced by MIS. Conclusion Overall survival and DFS after MIS for early-stage CC treatment were worse than those after ARH, especially for patients with a tumor >= 2 cm in diameter.