Lymphadenectomy alone is a feasible option in managing incidentally-detected early-stage cervical cancer after simple hysterectomy without intermediate-risk factors: An application of the concept of less radical surgery.
OBJECTIVE
To assess the feasibility of less radical surgery in patients with incidentally-detected cervical cancer at simple hysterectomy.


METHODS
High-risk factors (HFs) were evaluated in 104 patients who underwent radical hysterectomy and lymphadenectomy for the treatment of stage IA1-IB1 cervical cancer according to intermediate-risk factors (IFs).


RESULTS
Thirty-three patients without IFs had no HFs. As the number of IFs increased, the number of HFs increased (p=0.009). Multivariate analysis revealed that lymph node metastasis was the only independent risk factor for parametrial involvement (hazard ratio, 31.3; 95% confidence interval, 1.6-599.4; p=0.022). An absence of IFs was associated with a longer progression-free survival than the presence of IFs in the subgroup analysis of favorable histologies (p=0.044).


CONCLUSIONS
HFs could be excluded in stage IA1-IB1 cervical cancer without IFs. Omitting parametrectomy seems a feasible option for selected patients with incidentally-detected early-stage cervical cancer at simple hysterectomy, without IFs.
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea. ybkimlh@snubh.org.
Hye Won
HW
Jeon
Dong Hoon
DH
Suh
Kidong
K
Kim
Jae Hong
JH
No
Yong-Beom
YB
Kim
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D042241:Early Diagnosis; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000401:mortality*; D008197:Lymph Node Excision / Q000401:mortality*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
Cervical cancer; intermediate risk factor; less radical surgery; simple hysterectomy