KEY TAKEAWAYS
- The study aimed to evaluate the oncologic outcomes of simple hysterectomy in low-risk early-stage cervical cancer.
- The study found that simple hysterectomy with lymph node evaluation in low-risk early-stage cervical cancer had positive oncologic outcomes and reduced morbidity.
David Viveros-Carreño and the team conducted a study that aimed to assess oncologic outcomes following simple hysterectomy in low-risk early-stage cervical cancer patients (tumors ≤2 cm with limited stromal invasion).
The study, registered in PROSPERO (CRD42023433840), followed the PRISMA checklist. MEDLINE (via Ovid), Embase, and Cochrane Central Register of Controlled Trials were searched until June 2023. They included randomized controlled trials and observational studies comparing simple hysterectomy with lymph node assessment to radical hysterectomy with lymph node assessment in low-risk early-stage cervical cancer patients.
The initial search yielded 1270 articles; after deduplication, 18 studies were deemed potentially eligible, with 4 meeting the selection criteria. Among these, 3 were randomized controlled trials, and 1 was a retrospective cohort study with 981 patients. Of these, 485 (49.4%) were in the simple hysterectomy group, and 496 (50.6%) were in the radical hysterectomy group.
The results showed that simple hysterectomy with lymph node assessment did not exhibit a higher death risk at 5 years (RR 0.98, 95% CI: 0.31 to 3.10; I2=0%, two randomized controlled trials, 141 patients), with an absolute risk reduction of zero percentage points [95% CI -9.0 to 9.0]). Additionally, there were comparable rates of pelvic recurrence at 3 years (97.5% and 97.8% for simple hysterectomy and radical hysterectomy, respectively, P=0.79) and overall recurrence at 3 years (95% and 100% for simple hysterectomy and radical hysterectomy, respectively, P=0.30).
The study concluded that simple hysterectomy with lymph node evaluation in low-risk early-stage cervical cancer does not negatively impact oncologic outcomes and offers improved morbidity profiles.
The authors did not specify receiving a particular grant for this research from any public, commercial, or not-for-profit funding agency.
Source: https://pubmed.ncbi.nlm.nih.gov/38438182/
Trial registration: PROSPERO CRD42023433840
Viveros-Carreño D, Pareja R, Plante M, (2024). “De-escalation of surgical radicality for non-fertility preserving management in patients with early-stage cervical cancer: a systematic review.” International Journal of Gynecologic Cancer 2024;34:386-392.
