Less versus more radical surgery in stage IB1 cervical cancer: A population-based study of long-term survival

Gynecologic Oncology
Jill H TsengMario M Leitao

Abstract

Standard surgical treatment for women with stage IB1 cervical cancer consists of radical hysterectomy. This study assesses survival outcomes of those treated with less radical surgery (LRS; conization, trachelectomy, simple hysterectomy) compared to more radical surgery (MRS; modified radical, radical hysterectomy). Using the Surveillance, Epidemiology and End Results database, we identified women <45 years with FIGO stage IB1 cervical cancer diagnosed from 1/1998 to 12/2012. Only those who underwent lymph node (LN) assessment were analyzed. Disease-specific survivals (DSSs) of LRS were compared with those of MRS. Of 2571 patients, 807 underwent LRS and 1764 underwent MRS, all with LN assessment. For LRS vs. MRS, 28% vs. 23% were diagnosed with adenocarcinoma (p = 0.024), 31% vs. 39% had G3 disease (p < 0.001), 40% vs. 45% had tumor size >2 cm (p < 0.001), and 27% vs. 29% received adjuvant radiation therapy (p = 0.005). Median follow-up was 79 months (range, 0-179). Ten-year DSS for LRS vs. MRS was 93.5% vs. 92.3% (p = 0.511). There was no difference in 10-year DSS when stratified by tumor size ≤2 cm (LRS 95.1% vs. MRS 95.6%, p = 0.80) or > 2 cm (LRS 90.1% vs. MRS 88.2%, p = 0.48). Factors independently associated with increase...Continue Reading

Citations

Nov 28, 2018·Journal of Gynecologic Oncology·Jacobus van der Velden, Constantijne H Mom
Nov 26, 2019·Obstetrics and Gynecology·Julie My Van Nguyen, Allan Covens
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Mar 3, 2021·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Florencia NollFernando Heredia
Mar 3, 2021·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Javier BurbanoJuliana Rodriguez
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Sep 9, 2021·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Kathleen M SchmelerPedro T Ramirez

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