Our Summary

This study compared two types of surgeries used in treating early-stage, low-risk cervical cancer: radical hysterectomy, which is a more extensive operation, and simple hysterectomy, which is less invasive. The goal was to see if the simpler surgery was just as effective in preventing cancer recurrence in the pelvic area after three years. The study also looked at side effects, particularly urinary problems.

The research involved 700 patients, most of whom had a particular type of cervical cancer that’s usually less aggressive. The patients were split into two groups, with half undergoing the radical procedure and half the simpler one.

After three years, the rates of cancer recurrence were roughly the same for both groups. Meanwhile, the patients who had the simpler surgery were less likely to suffer from urinary problems such as incontinence and retention.

The conclusion is that for patients with this type of low-risk cervical cancer, the simpler surgery is just as effective in preventing recurrence and has fewer side effects. This could potentially lead to changes in how such patients are treated.

FAQs

  1. What was the main goal of this study on cervical cancer surgeries?
  2. What were the findings of this study in terms of cancer recurrence and side effects between radical and simple hysterectomy?
  3. Could the results of this study lead to changes in treatment for low-risk cervical cancer?

Doctor’s Tip

A helpful tip a doctor might tell a patient about radical hysterectomy is that while it is a more extensive surgery, in some cases a simpler hysterectomy may be just as effective in preventing cancer recurrence and may have fewer side effects such as urinary problems. It is important to discuss all treatment options with your doctor to determine the best course of action for your specific case.

Suitable For

Patients who are typically recommended radical hysterectomy are those with early-stage, low-risk cervical cancer. These patients may have a particular type of cervical cancer that is less aggressive and may benefit from the less invasive simple hysterectomy surgery. It is important for patients to discuss their specific case with their healthcare provider to determine the best treatment plan for their individual needs.

Timeline

Before the radical hysterectomy, a patient typically undergoes diagnostic tests such as a Pap smear, colposcopy, biopsy, and imaging studies to confirm the presence of cervical cancer. They may also undergo pre-operative evaluations such as blood tests, chest X-rays, and electrocardiograms to assess their overall health and fitness for surgery.

During the radical hysterectomy procedure, which involves the removal of the uterus, cervix, part of the vagina, and surrounding tissues, the patient is placed under general anesthesia and the surgeon makes an incision in the abdomen to access and remove the affected organs. The surgery can last several hours and may require a hospital stay of several days for recovery.

After the surgery, the patient may experience pain, discomfort, and fatigue as their body heals. They may also have temporary side effects such as vaginal bleeding, discharge, and urinary problems. It can take several weeks to months for the patient to fully recover and resume their normal activities.

In the follow-up care after the radical hysterectomy, the patient will have regular appointments with their healthcare provider for physical exams, imaging studies, and blood tests to monitor their recovery and check for any signs of cancer recurrence. They may also receive counseling and support to address any emotional or psychological challenges associated with the surgery and cancer diagnosis.

What to Ask Your Doctor

  1. What is a radical hysterectomy and how does it differ from a simple hysterectomy?

  2. What are the potential risks and benefits of undergoing a radical hysterectomy for my specific case of low-risk cervical cancer?

  3. How likely is it that a radical hysterectomy will prevent cancer recurrence compared to a simple hysterectomy?

  4. What are the possible short-term and long-term side effects of a radical hysterectomy, particularly in terms of urinary problems?

  5. Are there alternative treatment options to a radical hysterectomy that I should consider?

  6. How experienced are you in performing radical hysterectomies, and what is your success rate with this procedure?

  7. How long is the recovery period expected to be following a radical hysterectomy, and what kind of follow-up care will be needed?

  8. Will I still be able to have children after undergoing a radical hysterectomy?

  9. How will a radical hysterectomy affect my hormone levels and overall quality of life?

  10. Are there any clinical trials or research studies that I should be aware of that may impact my decision regarding treatment options for low-risk cervical cancer?

Reference

Authors: Plante M, Kwon JS, Ferguson S, Samouëlian V, Ferron G, Maulard A, de Kroon C, Van Driel W, Tidy J, Williamson K, Mahner S, Kommoss S, Goffin F, Tamussino K, Eyjólfsdóttir B, Kim JW, Gleeson N, Brotto L, Tu D, Shepherd LE; CX.5 SHAPE investigators; CX.5 SHAPE Investigators. Journal: N Engl J Med. 2024 Feb 29;390(9):819-829. doi: 10.1056/NEJMoa2308900. PMID: 38416430