Our Summary

This study looked at the effects of performing more extensive surgery on the survival rates of patients with early-stage cervical cancer. The researchers specifically focused on whether a ‘radical hysterectomy’ (a surgery that removes the uterus, cervix, part of the vagina, and lymph nodes in the area) improved the chances of survival for these patients, and whether preserving the nerves during surgery made any difference to survival rates.

To do this, they looked at the medical records of 1257 patients who had this type of surgery between 2007 and 2016. They found that patients who had the more extensive surgery without nerve preservation had a slightly better chance of survival after five years than those who had the nerve-preserving surgery.

However, when they looked more closely at the size of the tumors, they found that for smaller tumors (20mm or less), there was no difference in survival rates between the more and less extensive surgery. But for larger tumors (between 21 and 40mm), the more extensive surgery was associated with better survival rates.

In conclusion, the researchers suggest that for early-stage cervical cancer, the more extensive surgery might be beneficial for patients with larger tumors, but not for those with smaller ones.

FAQs

  1. What is a ‘radical hysterectomy’ and how does it relate to cervical cancer?
  2. Does nerve preservation during a radical hysterectomy affect survival rates of patients with early-stage cervical cancer?
  3. How does the size of the tumor affect the benefit of more extensive surgery in early-stage cervical cancer patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about radical hysterectomy is to discuss the size of the tumor and whether the more extensive surgery would be beneficial for their specific case. It’s important to have an open and honest conversation with your healthcare provider about the potential benefits and risks of the surgery in order to make an informed decision. Additionally, maintaining regular follow-up appointments and screenings after surgery is crucial for monitoring your health and detecting any potential recurrence of the cancer.

Suitable For

Patients with early-stage cervical cancer, particularly those with larger tumors (between 21 and 40mm), are typically recommended radical hysterectomy. This type of surgery is considered to be more beneficial for these patients in terms of improving survival rates. Nerve preservation during surgery may not make a significant difference in survival rates for these patients, but the extent of the surgery may have an impact on their outcomes. It is important for healthcare providers to consider the size of the tumor when determining the appropriate treatment approach for patients with early-stage cervical cancer.

Timeline

Before the radical hysterectomy, a patient may experience symptoms such as abnormal vaginal bleeding, pelvic pain, or pain during intercourse. They may undergo various tests and scans to diagnose the cervical cancer and determine the stage of the disease. The patient and their medical team will discuss treatment options, including the possibility of a radical hysterectomy.

After the surgery, the patient will typically stay in the hospital for a few days to recover. They may experience pain, fatigue, and discomfort in the pelvic area. They will need to follow a strict recovery plan, including avoiding heavy lifting and strenuous activities for several weeks. The patient may also need to undergo physical therapy to help with mobility and pelvic floor strength.

In the long term, the patient may experience changes in their sexual function and fertility, as a radical hysterectomy removes the uterus and cervix. They may also need to undergo regular follow-up appointments and screenings to monitor for any signs of cancer recurrence. With proper care and monitoring, many patients can go on to live healthy and fulfilling lives after a radical hysterectomy for cervical cancer.

What to Ask Your Doctor

Some questions a patient should ask their doctor about radical hysterectomy include:

  1. What are the potential risks and complications associated with a radical hysterectomy?
  2. How will a radical hysterectomy impact my quality of life, including fertility and sexual function?
  3. What are the expected outcomes and survival rates for patients who undergo a radical hysterectomy?
  4. Are there alternative treatment options available for my stage of cervical cancer?
  5. How will my recovery process look like after a radical hysterectomy?
  6. Will I need additional treatments, such as chemotherapy or radiation therapy, after the surgery?
  7. How experienced is the surgical team in performing radical hysterectomies for cervical cancer?
  8. Are there any specific criteria that determine whether I am a suitable candidate for a radical hysterectomy?
  9. How will my follow-up care and monitoring look like after the surgery?
  10. Can you explain in more detail the differences between a radical hysterectomy with nerve preservation and without nerve preservation, and how it may impact my prognosis?

Reference

Authors: Bizzarri N, Querleu D, Dostálek L, van Lonkhuijzen LRCW, Giannarelli D, Lopez A, Salehi S, Ayhan A, Kim SH, Ortiz DI, Klat J, Landoni F, Pareja R, Manchanda R, Kosťun J, Ramirez PT, Meydanli MM, Odetto D, Laky R, Zapardiel I, Weinberger V, Dos Reis R, Pedone Anchora L, Amaro K, Akilli H, Abu-Rustum NR, Salcedo-Hernández RA, Javůrková V, Mom CH, Scambia G, Falconer H, Cibula D. Journal: Am J Obstet Gynecol. 2023 Oct;229(4):428.e1-428.e12. doi: 10.1016/j.ajog.2023.06.030. Epub 2023 Jun 17. PMID: 37336255