Two studies out today raised concerns about a treatment for early stage cervical cancer that had gained favor in the U.S. The studies, published online in the New England Journal of Medicine, say minimally invasive surgery is actually worse for women than standard surgery.
"We are obviously all surprised about the findings", Dr. Joe-Alejandro Rauh-Hain, a gynecologic cancer specialist at MD Anderson who worked on one of the studies, told NBC News.
Both studies were published online October 31 in the New England Journal of Medicine.
Global Minimally Invasive Market Report provides data about manufacturers, including: shipment, price, revenue, gross profit, interview record, business distribution CAGR etc.
"I'm a huge minimally invasive surgeon, and for me it was like a dagger to the heart", says Dr. Noah Goldman, associate professor and vice chair of clinical affairs in obstetrics, gynecology and women's health at Rutgers, New Jersey Medical School. Embracing minimally-invasive surgery reversed that trend "and coincided with the beginning of a decline in the 4-year survival rate of 0.8 percent per year between 2006 and 2010", Wright's team reports in their paper.
An alternative explanation, he said, is that surgeons in the USA may have been less experienced with the minimally invasive procedure than with open surgery during the period of study. Their results showed that the rate of disease-free survival after four years was 90.9% for the minimally invasive surgery group and 94.7% for the open surgery group. Half had their uterus removed through open abdominal surgery; the other half had minimally invasive surgery.
But now, "given the burden of published evidence, minimally invasive surgery can not be considered as the standard of care for patients with early cervical cancer", he said. They randomly assigned women diagnosed with early stage cervical cancer to receive either a hysterectomy via minimally invasive surgery or robot-assisted surgery, or through the traditional open technique of making an incision in the abdomen. The study was supported by National Cancer Institute grants P30 CA016672, 4P30 CA060553-22, and R25 CA092203; National Institute of Child Health and Human Development grant K12 HD050121-12; and by the American Association of Obstetricians and Gynecologists Foundation, the Foundation for Women's Cancer, the Jean Donovan Estate and the Phebe Novakovic Fund.
"This is high-level evidence that we should not continue to perform minimally invasive surgery", Dr. Pedro Ramirez says.
In the study led by Ruah-Hain and Melamed, researchers assessed outcomes for almost 2,500 patients in the U.S. National Cancer Database who underwent radical hysterectomy for early stage cervical cancer from 2010 through 2013. "These patients are early stage cancer patients, and the intent of surgical treatment is cure".
Minimally Invasive Market Competition: organization profiles, item portfolios, limit, value, cost, gross and income of every one of the Minimally Invasive business key players are given. Most women with early-stage disease are treated with radical hysterectomy, which involves removing the uterus, cervix, and surrounding tissues. "I was mad", she said.
Ramirez first reported early results of the study at a conference last spring, and physicians have debated how it should change their treatment decisions ever since. "It included a large number of centers throughout the world, and all centers were required to demonstrate proficiency in minimally invasive surgery".
Although the reasons behind the higher recurrence and death rates are still unclear, it is possible that the laparoscopic cameras that they use during the minimally invasive procedures miss some of the tumors and end up being left behind. There were no differences between the groups in terms of tumor pathology or in the use of radiation or chemotherapy in addition to surgery. "We're definitely going to take a long, hard look at who we can offer the minimally invasive approach to", he says. Mainly, the complete scrutiny of the companies that are offered in the marketing and production of Cardiothoracic Minimally Invasive Surgical Instruments based on previous and futuristic market condition and market break down on the Cardiothoracic Minimally Invasive Surgical Instruments market segments that include Key Players, Types, Applications, Regions Moreover, a detailed study of Cardiothoracic Minimally Invasive Surgical Instruments market dynamic facts that provides a comprehensive estimation of the driving and growth factors, Cardiothoracic Minimally Invasive Surgical Instruments developing countries, various company norms, obstacles, and opportunities pertinent in the Cardiothoracic Minimally Invasive Surgical Instruments market report. He wasn't involved in the studies, but agreed they could change clinical practice.
What's more, the researchers noted that the national survival trend for early cervical cancer, which had been improving for years, started to decline in 2006, just as minimally invasive surgery started becoming popular.