Against the backdrop of the rapid iteration of global cervical cancer diagnosis and treatment technologies, the past year has witnessed multiple milestone research findings in this field, providing important evidence-based support for the clinical practice of minimally invasive treatment. Meanwhile, in response to the upgrading of women’s health needs and the innovation of cancer diagnosis and treatment concepts, minimally invasive treatment for cervical cancer is undergoing an in-depth transformation from technological exploration to precision individualization. As the year draws to a close, the Obstetrics and Gynecology Network specially invited Professor Wang Yudong, President of the International Peace Maternity and Child Health Hospital of China Welfare Institute, to sort out cutting-edge domestic and international advances, analyze core clinical controversies, and prospect the direction of disciplinary development, with the aim of providing references for the high-quality development of minimally invasive treatment for cervical cancer.
Three Major Research Advances in Minimally Invasive Surgery for Cervical Cancer
Minimally invasive surgery for cervical cancer has achieved three key advances in clinical research and technological application in recent years:
1. Locally Advanced Cervical Cancer – 5-Year OS of LRH-Karez Procedure Reaches 92% (ChiCTR2400095020)
For locally advanced cervical cancer, concurrent chemoradiotherapy (CCRT) is the first-line recommendation in international guidelines, yet radiotherapy failure remains a clinical challenge. Additionally, treatment regimens vary between European and Asian countries, and the optimal therapeutic strategy is still controversial; radical hysterectomy (RH) remains an important option. In addressing the existing controversies in minimally invasive cervical cancer surgery, improving surgical quality and strengthening surgeon training are the key breakthroughs.
A multicenter retrospective cohort study (ChiCTR2400095020) on the LRH-Karez procedure based on space anatomy, conducted by Professor Wang Yudong’s team, confirmed that for patients with locally advanced cervical cancer (FIGO stage IB3/IIA2), this procedure significantly improves survival prognosis compared with conventional minimally invasive surgery, with the 5-year overall survival (OS) rate reaching 92.2%. The clinical experience of this procedure in cervical cancer treatment was shared with global peers at the European Society for Gastrointestinal Endoscopic Surgery (ESGE) in October 2025.
2. Sentinel Lymph Node Dissection Alone Feasible for Early-Stage Cervical Cancer – The PHENIX Study
The PHENIX study published in 2025 indicated that for patients with early-stage cervical cancer, sentinel lymph node biopsy alone (96.9%) is non-inferior to lymphadenectomy (94.6%) in terms of 3-year disease-free survival, with a lower complication rate. Enrolled patients were staged as FIGO IA1 (with lymphovascular space invasion), IA2, IB1 or IIA1 according to the 2009 International Federation of Gynecology and Obstetrics (FIGO) criteria. The enrollment criterion of the PHENIX study was cervical tumor ≤3 cm, and minimally invasive surgery accounted for 61% of the procedures. This study is expected to promote the omission of systematic pelvic lymphadenectomy in early-stage cervical cancer patients with negative sentinel lymph nodes (SLN).
3. Simple Hysterectomy Applicable for Early Low-Risk Cervical Cancer – The SHAPE Study
The 2024 SHAPE trial demonstrated that in patients with low-risk early-stage cervical cancer (FIGO IA2/IB1, tumor ≤2 cm, depth of invasion <10 mm, etc.), simple hysterectomy is non-inferior to radical hysterectomy in terms of 3-year pelvic recurrence rate, supporting a more conservative surgical approach. In the SHAPE trial, 83% of simple hysterectomies were performed via minimally invasive surgery, with a low recurrence rate of 3.1%.
Based on the 2nd and 3rd research advances, simple hysterectomy (+SLND) may be recommended for strictly defined early-stage, low-risk cervical cancer; however, a more standardized diagnostic approach is required for early-stage cervical cancer.
Selection of Minimally Invasive Surgical Approaches for Cervical Cancer (Robotic vs Laparoscopic)
In minimally invasive cervical cancer surgery, the core considerations for choosing robotic or laparoscopic surgery are visual field clarity and instrument maneuverability, which directly determine surgical quality and patient safety. At present, clinicians should prioritize the equipment they are most familiar with and proficient in to ensure procedural safety.
Laparoscopic surgery features high popularity, a short training cycle and easy implementation. Robotic surgery represents the future development direction of laparoscopic surgery, as it provides three-dimensional high-definition vision and flexible instruments, with prominent advantages especially in deep-field operation and delicate suturing. Nevertheless, it has a longer learning curve, may prolong surgical time in the early stage of mastery, and requires specialized training.
Regardless of the equipment used, the surgeon’s experience and technical proficiency remain the decisive factor. Experienced surgeons can better manage complex intraoperative situations, reduce complications, and help achieve optimal oncological outcomes.
Challenges and Solutions for Tailor-Made Minimally Invasive Treatment of Cervical Cancer
Tailor-made treatment refers to individualized surgical therapy for patients, which is the ideal goal of cervical cancer surgery. Currently, the biggest challenge to this goal is the accuracy of clinical staging of cervical cancer – only based on accurate staging can appropriate surgical extent be determined. Therefore, we need to leverage MRI and other imaging technologies to improve the accuracy of clinical staging for cervical cancer.
The core solution lies in seeing clearer and judging more accurately, which requires breakthroughs in imaging technologies and diagnostic modalities.
Conclusion
Over the past year, breakthroughs in international cutting-edge research and clinical practice by domestic teams have jointly driven the development of minimally invasive cervical cancer treatment. The upgrading of cancer diagnosis and treatment concepts and the iteration of minimally invasive technologies further require us to take precision as the core and standardization as the guideline, and construct a new diagnosis and treatment system covering precise staging, homogeneous operation and individualized treatment. This is not only the era mission of the disciplinary development of minimally invasive cervical cancer treatment, but also the inevitable path to safeguarding women’s cervical health.
Expert Profile
Professor Wang Yudong
International Peace Maternity and Child Health Hospital of China Welfare Institute
Medical Doctor, Chief Physician, Doctoral Supervisor of Shanghai Jiao Tong University School of Medicine, President of the International Peace Maternity and Child Health Hospital of China Welfare Institute.
He is a Visiting Scholar at The James Cancer Hospital in Ohio, a recipient of the Shanghai Eastern Talent title, an Outstanding Academic Leader in Shanghai Health System, an Outstanding Academic Leader of Shanghai, and a Shanghai Craftsman.
Professor Wang has long been engaged in clinical and applied research on gynecological oncology and reproduction, and specializes in minimally invasive surgery for gynecological tumors.
He holds academic positions including Standing Committee Member of the Obstetrics and Gynecology Branch of the Chinese Medical Doctor Association, Chairperson of the Oncofertility Branch of the Chinese Eugenics Science Association, and Vice Chairperson of the Obstetrics and Gynecology Branch of the Shanghai Medical Association.
Editor: Lily
