Maximally effective.

If retrospective and even prospective randomized studies weren’t enough, here’s a meta-analysis providing even more evidence that minimally invasive hysterectomies for early-stage cervical cancer confer worse survival than the tried and true open techniques. Among nearly 10K women included in 15 observational studies, half received minimally-invasive surgery, and half of those were robot-assisted. The pooled hazard of recurrence or death was significantly higher with minimally invasive surgery (HR 1.71), as it was of death (HR 1.56), and this wasn’t limited to only robot-assisted cases. What’s more, there was low heterogeneity among study findings. TBL: A broad look at outcomes further confirms a survival detriment with minimally invasive surgical techniques for early-stage cervical cancer. | Nitecki, JAMA Oncol 2020