Robotic versus open surgery for early cervical cancer

A study enrolling patients at Providence Cancer Institute aims to play a critical role in guiding surgeons and patients toward the most effective and safe surgical options for early cervical cancer. The Robotic Approach to Cervical Cancer (ROCC) clinical trial is being conducted at sites in North America that have demonstrated expertise in robotic surgery. Over 800 participants may enroll.  

The principal investigator at Providence Cancer Institute is Christopher Darus, M.D., medical director, Providence Gynecologic Oncology Program.  

Is robotic-assisted surgery safer? 

While cervical cancer rates are declining in high-income countries, more than 11,000 women in the United States will still be diagnosed with this gynecologic cancer in 2025. Early-stage cases are typically treated with surgery to remove the uterus (hysterectomy) and assess the lymph nodes. Depending on risk factors, this may involve either a simple hysterectomy (removal of the uterus) or a more extensive radical hysterectomy (removal of the uterus and surrounding tissue).    

Open surgery, the traditional approach, has a long track record of success. But this type of surgery often comes with: 

In recent years, minimally invasive surgery, including laparoscopy and robotic-assisted surgery, has become more common. The benefits of minimally invasive surgery include:  

However, earlier studies suggested that minimally invasive surgery might be linked to higher cervical cancer recurrence rates. Most of these studies focused on non-robotic laparoscopy and did not require surgeons to have expertise in minimally invasive radical hysterectomy, or ensure proper tumor containment during surgery. 

The ROCC trial aims to determine whether robotic-assisted surgery is as safe and effective as open surgery. Unlike past studies, it sets higher standards by requiring participating surgeons to demonstrate expertise and follow strict tumor containment measures. These safeguards will help provide more definitive answers about the best surgical approach for cervical cancer. 

What study participants can expect 

For eligible participants, the trial is an opportunity to contribute to groundbreaking research while receiving high-quality surgical care. All surgeries in the study are performed by highly trained gynecologic oncologists who follow strict protocols to ensure patient safety.  

Study participants undergoing surgery are randomly assigned to one of two groups:   

Before surgery starts, physicians carefully examine the abdominal area to check for any signs that the cancer has spread. If cancer has visibly spread to other areas, the surgery may be stopped, and the patient will not continue in the study.  

Interested in learning more? 

If you’ve been diagnosed with early-stage cervical cancer and are considering your treatment options, ask your doctor whether participating in a clinical trial like ROCC could be right for you. 

Get more details about the study: 

A Randomized Controlled Trial of Robotic versus Open Radical Hysterectomy for Early-Stage Cervical Cancer (ROCC trial) 

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