To identify whether the use of a uterine manipulator or intracorporeal colpotomy conferred inferior short-term survival among patients treated for early-stage cervical cancer.

Retrospective cohort study.

Tertiary university-based hospital.

1169 patients with stage IB1-IB2 cervical cancer

All patients underwent minimally invasive radical hysterectomy and pelvic lymphadenectomy.

A total of 1169 patients diagnosed with preoperative stage IB1-IB2 cervical cancer were primarily treated with surgery from 2018 to 2019. The eligible patients had a median age of 48 years (range: 23–76 years), and the median follow-up time was 34 months (range:3.57–50.87 months). The 2-year overall survival rate of the patients with pathological stage IB1 and IB2 was 99.8% and 98.8%, respectively, according to the 2018 Federation of Gynecology and Obstetrics staging system. Univariable analysis revealed that the uterine manipulator free group had a 7.6-times higher risk of death compared with that of the manipulator free group (p=.006), but multivariable analysis clarified that only tumor size (p=.016, hazard ratio [HR] 2.285, 95% confidence interval [CI] 1.166-4.479) and parametrial involvement (p=.003, HR 3.556, 95% CI 1.549-8.166) were independent risk factors for overall survival. There was no statistically significant difference in survival between patients that underwent either intracorporeal or protective colpotomy.

Short-term survival outcomes in women undergoing minimally invasive radical hysterectomy for treatment of early-stage cervical cancer did not differ when a uterine manipulator was avoided or when a protective colpotomy was performed.