Simple SummaryTo investigate the efficacy of minimally invasive surgery (MIS) in the treatment of uterine-confined and node-negative cervical cancer in Japan, we conducted a population-based study using Osaka Cancer Registry data ranging between 2011 and 2018. A total of 2279 patients who underwent surgical treatment for uterine-confined and node-negative cervical cancer were identified. The patients were classified into groups according to surgery type (open and MIS groups) and year of diagnosis (2011–2014 and 2015–2018), and their oncologic outcomes were compared between the MIS and open groups. In the analyses including all patients, i.e., patients diagnosed in 2011–2014 and those diagnosed in 2015–2018, there were no differences in overall survival between the MIS and open groups. Our population-based cohort study provides epidemiological evidence that MIS does not compromise survival outcomes when compared with conventional open surgery in Japanese patients with FIGO 2018 stage I cervical cancer.AbstractWe aimed to compare the oncological outcomes between Japanese women with uterine-confined and node-negative cervical cancer who underwent open surgery and those who underwent minimally invasive surgery (MIS). A population-based retrospective cohort study was conducted using data from the Osaka Cancer Registry that ranged from 2011 to 2018. A total of 2279 patients who underwent surgical treatment for uterine-confined and node-negative cervical cancer were identified. The patients were classified into groups according to surgery type (open and MIS groups) and year of diagnosis (group one, 2011–2014; group two, 2015–2018). The oncologic outcomes were compared between the MIS and open groups. When the MIS group (n = 225) was compared with open group (n = 2054), overall, there was no significant between-group difference in terms of overall survival. Based on Kaplan–Meier estimates, the probability of overall survival at four years was 99.5% in the MIS group and 97.2% in the open group (p= 0.1110). When examined according to the year of diagnosis, there were no significant between-group differences in the overall survival in both groups one and two. In this population-based cohort study, MIS did not compromise survival outcomes when compared with conventional open surgery in Japanese patients with uterine-confined and node-negative (FIGO 2018 stage I) cervical cancer.