Is It Possible to Perform Less Radical Surgery for Invasive Uterine Cervical Cancer?

Gynecol Obstet Invest. 2016;81(3):251-5. doi: 10.1159/000439528. Epub 2015 Nov 20.

Abstract

Background/aims: A retrospective analysis was performed to evaluate the possibility of less radical surgery for early-stage invasive uterine cervical cancer without compromising the oncological outcome.

Methods: The analysis was performed on 175 patients with invasive uterine cervical cancer in FIGO stage IA2-IIB, all of whom underwent primary radical hysterectomy. Relationship of tumor size with the incidence of pathologic parametrial involvement and the pelvic lymph node metastasis were investigated.

Results: Fifty-one patients had tumor size ≤2 cm and 124 had tumor size >2 cm. Patients with tumor size ≤2 cm had a significantly lower incidence of parametrial invasion (p < 0.0001), lymph node metastasis (p < 0.0001), lymph vascular space involvement (p < 0.0001) and recurrence (p = 0.0002) than patients with tumor size >2 cm. Five-year relapse-free survival rate was 98 and 73%, respectively (p = 0.0004).

Conclusion: It is suggested that less radical surgery may be appropriate for some cases with tumor size <2 cm.

MeSH terms

  • Adult
  • Aged
  • Chemotherapy, Adjuvant
  • Female
  • Gynecologic Surgical Procedures / methods*
  • Humans
  • Hysterectomy
  • Lymphatic Metastasis / pathology
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Pelvis
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*