Photo Credit: Lavrentyeva

The following is a summary of “Survival After Simple Compared With Radical Hysterectomy for Patients With Early-Stage Cervical Cancer,” published in the September 2024 issue of Obstetrics and Gynecology by Viveros et al.      

Cervical cancer is a notable health concern, and the role of surgery in early-stage cases remains unclear.  

Researchers conducted a retrospective study assessing the effect on overall survival (OS) of simple hysterectomy with lymph node staging compared to radical hysterectomy with lymph node staging for patients with early-stage cervical cancer.  

They analyzed the National Cancer Database, focusing on patients diagnosed with early cervical carcinoma measuring 2 cm or smaller (stage IA1 with lymphovascular space invasion through IIA1, International Federation of Gynecology and Obstetrics staging) between 2010 and 2019. After conducting 1:1 propensity score matching based on age, tumor size, race and ethnicity, lymphovascular space invasion, year of diagnosis, Charlson–Deyo comorbidity score, histology, and surgical approach, 1,529 patients in each group were compared.  

The results showed no statistical difference in OS between patients who underwent simple hysterectomy and those who underwent radical hysterectomy (HR 1.25, 95% CI, 0.91–1.73, P =.17). Subgroup analysis by histology, lymphovascular space invasion, tumor size, and surgical approach also did not reveal significant differences in OS according to hysterectomy type. Additionally, the hysterectomy groups did not significantly differ in 30-day readmission rate (4.6% vs. 4.2%, P=.73), 30-day mortality rate (0.1% vs. 0%, P =.14), or 90-day mortality rate (0.1% vs. 0.1%, P=.93).  

They concluded that patients with low-risk cervical cancer could undergo less radical surgery without adversely affecting the oncologic outcomes.  

Source: journals.lww.com/greenjournal/abstract/9900/survival_after_simple_compared_with_radical.1156.aspx