AIM Lately, the safety of minimally invasive surgery (MIS) in the treatment of cervical cancer (CC) has been questioned. This study aimed to evaluate the risk of recurrence and survival after a nationwide adoption of robotic MIS for the treatment of early-stage CC in Denmark. METHODS Population-based data on all Danish women with early-stage CC, who underwent radical hysterectomy January 1st 2005-June 30th 2017 were retrieved from the Danish Gynecologic Cancer Database and enriched with follow-up data on recurrence, death and cause of death. The cohort was divided into two groups according to the year of robotic MIS introduction at each cancer centre. Chi-squared or Fischer test, the Kaplan Meier method and multivariate Cox regression were used for comparison between groups. RESULTS One thousand one hundred twenty-five patients with CC were included; 530 underwent surgery before (group 1) and 595 underwent surgery after (group 2) the introduction of robotic MIS. The 5-year rate of recurrence was low: 8.2% and 6.3% (p = 0.55) in group 1 and 2, respectively. In adjusted analyses, this corresponded to a five-year disease-free survival, hazard ratio (HR) 1.23 [95% confidence interval (CI) 0.79-1.93]. No difference in site of recurrence (P = 0.19) was observed. The cumulative cancer-specific survival was 94.1% and 95.9% (P = 0.10) in group 1 and 2, respectively, corresponding to a HR 0.60 [95% CI 0.32-1.11] in adjusted analyses. CONCLUSION In this population-based cohort study, the Danish nationwide adoption of robotic MIS for early-stage CC was not associated with increased risk of recurrence or reduction in survival outcomes.

中文翻译：

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在全国范围内采用机器人微创手术治疗早期宫颈癌后的生存率-一项基于人群的研究。

目的最近，对微创手术（MIS）治疗子宫颈癌（CC）的安全性提出了质疑。这项研究旨在评估在丹麦全国范围采用机器人MIS治疗早期CC术后复发和生存的风险。方法从丹麦妇科癌症数据库中检索2005年1月1日至2017年6月30日接受根治性子宫切除术的所有丹麦早期CC患者的基于人群的数据，并丰富了有关复发，死亡和死亡原因的后续数据。根据每个癌症中心采用机器人MIS的年份，将队列分为两组。卡方检验或Fischer检验，Kaplan Meier方法和多元Cox回归用于组间比较。结果共纳入1152例CC患者。530例（第1组）接受了手术，595例（第2组）接受了机器人MIS手术。5年复发率很低：第1组和第2组分别为8.2％和6.3％（p = 0.55）。在调整后的分析中，这相当于五年无病生存率，危险比（HR）1.23 [95％置信区间（CI）0.79-1.93]。没有观察到复发部位的差异（P = 0.19）。第1组和第2组的癌症特异性累积生存率分别为94.1％和95.9％（P = 0.10），对应于调整后分析中的HR 0.60 [95％CI 0.32-1.11]。结论在这项基于人群的队列研究中，