Radical Surgery With Individualized Postoperative Radiation for Stage IB Cervical Cancer: Oncologic Outcomes and Severe Complications

Abstract

The majority of women with stages IB1-IB2 cervical cancer undergoing radical surgery do not require adjuvant RT, have excellent oncologic outcome, and have low severe complication rates. Nearly one third of our patients required postoperative radiation, with no statistically significant increase in severe complication rate and with similar oncologic outcomes compared with the surgery-only cohort. These data support the continued practice of radical surgery with individualized postoperative radiation for these patients.

Evaluation of Clinical and Pathologic Risk Factors May Reduce the Rate of Multimodality Treatment of Early Cervical Cancer

“…Of note, the "late complications" including a few cases of short small bowel obstructions and proctitis, which are probably exclusively related to the adjuvant RT were significantly higher. 41 Table 3 summarizes available studies concerning the complication rates reported in the treatment of early cervical cancer. As shown, there are no randomized studies comparing surgery to chemoradiation, and it is difficult to compare the different results because of the variability in grades and types of reported toxicities.…”

Morbidity after surgical management of cervical cancer in low and middle income countries: A systematic review and meta-analysis

“…Currently patients in LMIC are over-represented in reports of global rates of adverse surgical outcomes[8], with women’s cancers having been long neglected in these settings[9]. Allowing for variations in reporting, overall complication rates for radical hysterectomy are, often from single centres[10], reported at up to 37% [11, 12], and rates of individual complications, e.g. voiding dysfunction, are reported at up to 42%[13, 14].…”

Nerve-sparing radical hysterectomy versus conventional radical hysterectomy in early-stage cervical cancer. A systematic review and meta-analysis of survival and quality of life

“…2, taking considerable heterogeneity into account, there is no evidence of inferior disease-free and overall survival after NSRH in early stage cervical cancer. One can argue that some (single-centre) cohorts of RH do claim higher survival rates [58,59]. However such studies are prone to numerous kinds of bias.…”