Minimally invasive surgery in cervical cancer.

Abstract

In recent years, minimally invasive surgery has replaced open surgery for almost all surgical indications in gynecological practice. Recently, the results of the Laparoscopic Approach to Cervical Cancer (LACC) trial questioned the role of minimally invasive surgery for patients affected by earlystage cervical cancer. In the present paper, we discussed the current evidence regarding the adoption of minimally invasive surgery for patients with cervical cancer. We evaluated the current evidence focusing on four interesting features: (i) the impact of tumor volume; (ii) reasons explaining worse outcomes of patients undergoing minimally invasive surgery; (iii) methods to reduce the risk of recurrence during minimally invasive surgery; and (iv) the effect of minimally invasive surgery in patients with locally advanced cervical cancer. At the moment, in the light of current evidence, minimally invasive radical hysterectomy should be offered only in the context of clinical trials. Extensive counseling and appropriate patients' selection are needed. Further prospective evidence is warranted to identify the better approach for cervical cancer patients.