Minimally invasive surgery and quality of life in cervical cancer

In The Lancet Oncology, Michael Frumovitz and colleagues1 report quality-of-life outcomes of the randomised, phase 3, non-inferiority LACC trial.2 In the LACC trial, patients with early stage cervical cancer were randomly assigned (1:1) to receive open radical hysterectomy or minimally invasive surgery. At 3 years, compared with the open radical hysterectomy group, patients in the minimally invasive surgery group had worse disease-free survival (97·1% vs 91.2%; hazard ratio [HR] 3·74, 95% CI 1·63–8·58; p=0·002) and overall survival (99·0% vs 93·8%; HR 6·00, 1·77–20·30). On the basis of these results, in 2019, the National Comprehensive Cancer Network guidelines and the European Society of Gynaecological Oncology Scientific Committee recommended that the open approach should be considered the gold standard surgical approach for the treatment of early stage cervical cancer.