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For the last decade, minimally invasive surgeries have been preferred gynecologists for early-stage cervical cancer treatment. After all, they have lead to a lower risk of infection and faster recovery for patients. But this method, also known as laparoscopy, is less effective than its invasive counterpart.
The two studies were both published in the New England Journal of Medicine, and reported by TIME. The researchers compared the long-term survival outcome of two types of hysterectomy (uterus removal) procedures: minimally invasive surgery and open surgery.
Both analyzes found that the minimally invasive procedure had a lower survival rate.
The first study was led by Dr. Pedro Ramirez, a professor at the University of Texas MD Anderson Cancer Center. His team of researchers divided a group of approximately 600 patients in half and assigned to either minimally invasive surgery or open surgery. But the study has been discontinued because the minimally invasive surgery has shown a dramatically lower survival rate.
Specifically, according to the study, the rate of disease-free survival at 4.5 years was 86% for the minimally invasive surgery group, compared to 96.5% for the open surgery group. In addition, the minimally invasive surgery group had a lower overall survival rate than the open surgery group (93.8% versus 99%) and a higher rate of death from cervical cancer (4.4% as compared to 0.6%).
The second study, which was led by Dr. Alexander Melamed, a gynecologist oncologist at Massachusetts General Hospital, found similarly surprising results. The researchers looked at 2,461 women, about half of whom underwent minimally invasive surgery and half did open surgery. Their results have been shown to be less than 90.9% for the minimally invasive surgery group and 94.7% for the open surgery group.
"When you have a cancer like early-stage cervical cancer, that's a big difference," Dr. Alejandro Rauh-Hain, a gynecologist oncologist at the University of Texas MD Anderson Cancer Center who worked on the second study, told INSIDER.
The findings of the study were shocking to many members of the gynecologic oncology community, including Dr. Julian Schink, Chief of Gynecology Oncology at Cancer Treatment Centers of America. Schink has been practicing minimally invasive surgeries for the past 15 years.
"This is the first piece of compelling data that shows one procedure is inferior," he told INSIDER. Though Schink said this was shocking and disheartening on a personal level, he is grateful for the information.
"It is our responsibility, as we adopt new technologies, to confirm the changes we made are effective," he said.
Researchers do not know why the modern treatment is less effective
It is also important to understand why the less invasive surgery is not effective – a question the researchers of these two studies are still trying to resolve.
But one factor they can rule out is residual tumors. According to Ramirez's study, there was no evidence that women who underwent the minimally invasive surgery had more residual tumors than those who received open surgery.
Read more:6 things you need to know about HPV
As a result of these findings, the National Comprehensive Cancer Network (NCCN) is reporting on early-stage cervical cancer to an open hysterectomy. Schink and Rauh-Hain also told INSIDER that they plan to stop practicing minimally invasive procedures to treat early-stage cervical cancer.
Rauh-Hain added, however, that patients and practitioners should have an open conversation about the findings of these studies.
Additionally, Schink said patients should remember that the study only focused on cervical cancer, which is just one type of gynecological cancer. In the case of endometrial cancer, he said.
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