BackgroundThis study compared the survival outcomes of abdominal radical hysterectomy (ARH) (N= 32), laparoscopic radical hysterectomy (LRH) (N= 61), robot-assisted radical hysterectomy (RRH) (N= 100) and vaginal radical hysterectomy (VRH) (N= 45) approaches for early-stage cervical cancer to identify the surgical approach that provides the best survival.MethodsDisease-free survival (DFS) and overall survival (OS) were calculated using the Kaplan–Meier method, and survival curves were compared using the log-rank test.ResultsThe volume of intraoperative blood loss was greater in the ARH group than in the LRH group, the RRH group or the VRH group [(712.50 ± 407.59) vs. (224.43 ± 191.89), (109.80 ± 92.98) and (216.67 ± 176.78) ml, respectively;P< 0.001]. Total 5-year OS was significantly different among the four groups (ARH, 96.88%; LRH, 82.45%; RRH, 94.18%; VRH, 91.49%;P= 0.015). However, no significant difference in 5-year DFS was observed among the four groups (ARH, 96.88%; LRH, 81.99%; RRH, 91.38%; VRH, 87.27%;P= 0.061).ConclusionThis retrospective study demonstrated that ARH and RRH achieved higher 5-year OS rates than LRH for early-stage cervical cancer.