A late-stage trial of women with cervical cancer at low risk of advancement discovered that a basic hysterectomy rather than a radical hysterectomy resulted in equal outcomes in terms of keeping them cancer-free, a discovery that some doctors think might be “practice-changing.”
The trial’s findings, which were released on Friday at the American Society of Clinical Oncology’s annual meeting in Chicago, also revealed that patients who underwent the less complicated procedure experienced fewer problems and had a higher quality of life.
Both the uterus and the cervix are removed during a straightforward hysterectomy. The fallopian tubes, ovaries, lymph nodes, and vagina are often left in situ but can alternatively be removed. The procedure can be carried out by an incision in the abdomen, a tiny incision in the vagina, or even through laparoscopic surgery, in which a surgeon inserts a surgical tool through a tiny incision in the patient’s skin.
A radical hysterectomy involves the removal of the uterus together with the accompanying cervix, vagina, and a large region of tissues and ligaments around these organs. Early-stage cervical cancer is most frequently treated with this kind of surgery. According to the National Cancer Institute, the cancer has an 80% chance of being cured, although surgery can have serious adverse effects.
Doctors have wondered if a less invasive operation might be performed so patients may live longer but also have a better quality of life because such surgery can cause bladder and bowel issues as well as diminish sexual function. More women are presenting with cervical cancer at younger ages and earlier stages because to more thorough screening.
According to Dr. Marie Plante, a professor in the Department of Obstetrics and Gynecology at University Laval in Quebec and a research co-author, the tendency in recent years has been to perform a less invasive operation on women with low-risk cervical cancer. Retrospective data studies tend to indicate that a less invasive surgery may be a safe choice and may result in fewer complications.
In the new study, Plante and her coworkers conducted a late-stage randomized trial, contrasting simple hysterectomy and pelvic node dissection against radical hysterectomy and pelvic node dissection in patients with low-risk early-stage cervical cancer. The researchers were supported by the Canadian Institutes of Health Research and the Canadian Cancer Society. In a three-year study, women were randomly assigned to get either a simple hysterectomy in the experimental group or a radical hysterectomy in the control group.
The research represents a “long-awaited advance in the field,” according to Dr. Kathleen Moore, professor of gynecologic oncology at the University of Oklahoma Health Sciences Centre and holder of the Virginia Kerley Cade Endowed Chair in Cancer Developmental Therapeutics.
For women with cervical cancer, this is really important, according to Moore, who wasn’t involved in the study.
It might “change the trajectory of cervical cancer globally” if the findings prompt surgeons to adjust their practices, according to the researcher.
According to Moore, cervical cancer is not common in the US or Canada, but it is widespread in low- and middle-income nations. According to the World Health Organization, there are 600,000 instances of cervical cancer worldwide each year, with over 350,000 deaths occurring, largely in low- and middle-income nations.
