David Andi Wijaya, Nicolas Daniel Widjanarko, Christian Ambrosius Soeiono, Gulam Gumilar, Bartolomeus Alvin Tjandra
Background: Evidence regarding the oncological safety and effectiveness of combining minimally invasive surgery (MIS) with radiotherapy (RT) as an adjuvant therapy for cervical cancer remains limited. Also, several safety concerns regarding MIS in cervical cancer treatment have been found in a randomized controlled trial conducted in comparison to ORH. This study aims to objectify the recurrence rate and death associated with the different modalities with RT as an adjuvant treatment in International Federation of Gynecology and Obstetrics (FIGO) stage IA–IIB cervical cancer within the included observational studies. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO. A comprehensive search of PubMed, Scopus, EuropePMC, and Springer was performed to identify observational or interventional studies including women with FIGO stage IA–IIB cervical cancer who received adjuvant radiotherapy following MIS or open radical hysterectomy (ORH). Eligible studies reported survival or recurrence outcomes. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Results: Six observational studies involving 1,346 patients were included. Across studies, adjuvant radiotherapy was associated with improved local control and recurrence-related outcomes after both MIS and ORH. The benefit appeared more pronounced after MIS, while safety outcomes were inconsistently reported, limiting direct toxicity comparisons. Conclusions: Adjuvant RT plays a role in potentially improving the survival and prognostic factors of patient with cervical cancer FIGO stage IA–IIB who receive both MIS and ORH. However, due to the current limited amount of evidence, a further exploration on the role of adjuvant RT on MIS is needed. © 2026, AME Publishing Company. All rights reserved.© AME Publishing Company, Taiwan Society for Therapeutic Radiology and Oncology.
Department of Radiation Oncology, Dr. Kanujoso Djatiwibowo Regional General Hospital, North Balikpapan Regency, Jl. MT Haryono No. 656, Batu Ampar, Kec. Balikpapan Utara, Kota Balikpapan, Balikpapan, 76115, Indonesia; Master of Public Health in Occupational and Environmental Health, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Master of Public Health in Occupational and Environmental Health, Boston, MA, United States; School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia; Faculty of Medicine, Brawijaya University, Malang, Indonesia; Department of Obstetrics and Gynecology, Dr. Kanujoso Djatiwibowo Regional General Hospital, North Balikpapan Regency, Balikpapan, Indonesia
