Women with early cervical cancer having radical hysterectomy are at greater risk of recurrence and death if they have minimally invasive rather than open surgery, according to a meta-analysis.

In 2018, results of the LACC (Laparoscopic Approach to Cervical Cancer) trial surprised clinicians with a finding of four times the risk of recurrence and six times the risk of death in women randomised to laparoscopic procedure compared to those having laparotomy.

US researchers have now carried out a systematic review of 15 high-quality observational studies, including nearly 9500 women with stage IA1-IIA cervical cancer, comparing outcomes among those undergoing minimally invasive radical hysterectomy with those having traditional open surgery.

Control for confounders such as tumour size and at least two years of follow-up data were among the strict inclusion criteria, the researchers reported in JAMA Oncology.