Aim: Recently, the safety of laparoscopic radical hysterectomy (LRH) has been called into question in early-stage cervical cancer. This study aimed to evaluate overall survival (OS) and disease-free survival (DFS) in patients treated with abdominal radical hysterectomy (ARH) and LRH for early-stage cervical cancer and to provide a literature review.

The necessity of pelvic lymph node assessment in microinvasive cervical cancer depends on LVSI and histological subtype • Lymph node assessment is essential in any tumour with LVSI • Lymph node assessment can be omitted in squamous cell carcinoma without LVSI • Lymph node assessment can be omitted in adenocarcinoma with b3 mm depth of invasion • Lymph node assessment can be omitted in tumours without LVSI and with b3 mm depth of invasion

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Introduction To establish the impact of the number of lymph node metastases (nLNM) and the lymph node ratio (LNR) on survival in patients with early‐stage cervical cancer after surgery. Material and methods In this nationwide historical cohort study, all women diagnosed between 1995 and 2020 with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IA2–IIA1 cervical cancer and nodal metastases after radical hysterectomy and pelvic lymphadenectomy from the Netherlands Cancer Registry were selected. Optimal cut‐offs for prognostic stratification by nLNM and LNR were calculated to categorize patients into low‐risk or high‐risk groups. Kaplan–Meier overall survival analysis and flexible parametric relative survival analysis were used to determine the impact of nLNM and LNR on survival. Missing data were imputed. Results The optimal cut‐off point was ≥4 for nLNM and ≥0.177 for LNR. Of the 593 women included, 500 and 501 (both 84%) were categorized into the low‐risk and 93 and 92 (both 16%) into the high‐risk groups for nLNM and LNR, respectively. Both high‐risk groups had a worse 5‐year overall survival (p < 0.001) compared with the low‐risk groups. Being classified into the high‐risk groups is an independent risk factor for relative survival, with excess hazard ratios of 2.4 (95% confidence interval 1.6–3.5) for nLNM and 2.5 (95% confidence interval 1.7–3.8) for LNR. Conclusions Presenting a patient's nodal status postoperatively by the number of positive nodes, or by the nodal ratio, can support further risk stratification regarding survival in the case of node‐positive early‐stage cervical cancer.

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Introduction: Centralization has, among other aspects, been argued to have an impact on quality of care in terms of surgical morbidity. Next, monitoring quality of care is essential in identifying areas of improvement. This nationwide cohort study was conducted to determine the rate of short-term surgical complications and to evaluate its possible predictors in women with early-stage cervical cancer. How to cite this article: Wenzel HHB, Kruitwagen RFPM, Nijman HW, et al. Short-term surgical complications after radical hysterectomy-A nationwide cohort study. Acta

This study aims to report trends in primary treatment and survival in cervical cancer (CC) to identify opportunities to improve clinical practice and disease outcome. Methods: Patients diagnosed with CC between 1989 and 2018 were identified from the Netherlands Cancer Registry (N Z 21,644). Trends in primary treatment and 5-year relative survival were analysed with the Cochran-Armitage trend test and multivariable Poisson regression, respectively. Results: In early CC, surgery remains the preferred treatment for ages 15e74. Overall, it was applied more often in younger than in older patients (92% in 15e44; 64% in 65e74). For 75þ, surgery use was stable over time (38%e41%, pZ0.368), while administration of radiotherapy decreased (57%e29%, p < 0.001). In locally advanced CC, chemoradiation use increased over time (5%e65%, p < 0.001). It was applied least often for 75þ, in which radiotherapy remains most common (54% in 2014e2018). In metastatic CC, chemotherapy use increased over time (11%e28%, p < 0.001), but varied across age groups (6%e40% in 2014e2018). In patients treated with primary chemoradiation, regardless of stage, brachytherapy use increased over time (p 0.001). Full cohort 5-year survival increased from 68% to 74% (relative excess risk 0.55; 95% confidence interval [0.50e0.62]). Increases were most significant in locally advanced CC (38%e60%; 0.55 [0.47e0.65]). Survival remained stable in 75þ (38%e34%; 0.82 [0.66 e1.02]).