title: Primary therapy for early-stage cervical cancer: radical hysterectomy vs radiation.
abstract: OBJECTIVE
  We compared survival for women with early-stage cervical cancer who were treated with primary radiation or radical hysterectomy.
  
  
  METHODS
  Patients in the Surveillance, Epidemiology, and End Results database with stage IB1-IIA cervical cancer were examined. Radical hysterectomy was compared with primary combination external-beam and brachytherapy radiation.
  
  
  RESULTS
  A total of 4885 patients were identified. Multivariate analysis showed that radical hysterectomy was associated with a 59% reduction in mortality rate (hazard ratio, 0.41; 95% confidence interval [CI], 0.35-0.50). After stratification by tumor size, hysterectomy was associated with a 62% reduction in mortality rate (hazard ratio, 0.38; 95% CI, 0.30-0.48) for tumors that were <4 cm in diameter and a 49% improvement in survival (hazard ratio, 0.51; 95% CI, 0.36-0.72) for tumors that were 4-6 cm in diameter. Among women with tumors that were >6 cm in size, survival was equivalent between radical hysterectomy and radiation.
  
  
  CONCLUSIONS
  Our data indicate that, in women with cervical cancer lesions of <6 cm, radical hysterectomy is superior to primary radiation.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Nisha
authors.initials: N
authors.lastname: Bansal
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Herzog
authors.forename: Richard E
authors.initials: RE
authors.lastname: Shaw
authors.forename: William M
authors.initials: WM
authors.lastname: Burke
authors.forename: Israel
authors.initials: I
authors.lastname: Deutsch
authors.forename: Jason D
authors.initials: JD
authors.lastname: Wright
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008875:Middle Aged; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*