title: Class I versus Class III radical hysterectomy in stage IB1 (tumor ≤ 2 cm) cervical cancer: a matched cohort study.
abstract: Background & Aims:The long-term oncological outcome of Class I hysterectomy to treat stage IB1 cervical cancer is unclear. The aim of the present study was to compare the surgical and long-term oncological outcomes of Class I hysterectomy and Class III radical hysterectomy for treatment of stage IB1 cervical cancer (tumor ≤ 2 cm).Methods:Seventy stage IB1 cervical cancer patients (tumor ≤ 2 cm) underwent Class I hysterectomy and 577 stage IB1 cervical cancer patients (tumor ≤ 2 cm) underwent Class III radical hysterectomy were matched with known risk factors for recurrence by greedy algorithm. Clinical, pathologic and follow-up data were retrospectively collected. Five-year survival outcomes were assessed using Kaplan-Meier model.Results:After matching, a total of 70 patient pairs (Class I - Class III) were included. The median follow-up times were 75 (range, 26-170) months in the Class III group and 75 (range, 27-168) months in the Class I group. The Class I and Class III group had similar 5-year recurrence-free survival rates (RFS) (98.6% vs. 97.1%,P= 0.56) and overall survival rates (OS) (100.0% vs. 98.5%,P= 0.32). Compared with the Class III group, the Class I group resulted in significantly shorter operating time, less intra-operative blood loss, less intraoperative complications, less postoperative complications, and shorter hospital stay.Conclusions:These findings suggest that Class I hysterectomy is an oncological safe alternative to Class III radical hysterectomy in treatment of stage IB1 cervical cancer (tumor ≤ 2 cm) and Class I hysterectomy is associated with fewer perioperative complication and earlier recovery.
authors.affiliation: Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Zhongshan Second Road 58, Guangzhou 510700, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Zhongshan Second Road 58, Guangzhou 510700, China.
authors.forename: Chun-Liang
authors.initials: CL
authors.lastname: Shang
authors.affiliation: Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Zhongshan Second Road 58, Guangzhou 510700, China.
authors.forename: Qi-Qiao
authors.initials: QQ
authors.lastname: Du
authors.affiliation: Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Zhongshan Second Road 58, Guangzhou 510700, China.
authors.forename: Di
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Zhongshan Second Road 58, Guangzhou 510700, China.
authors.forename: Yan-Chun
authors.initials: YC
authors.lastname: Liang
authors.affiliation: Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Zhongshan Second Road 58, Guangzhou 510700, China.
authors.forename: Tian-Yu
authors.initials: TY
authors.lastname: Liu
authors.affiliation: Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Zhongshan Second Road 58, Guangzhou 510700, China.
authors.forename: Jia-Ming
authors.initials: JM
authors.lastname: Huang
authors.affiliation: Department of Obstetrics and Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Zhongshan Second Road 58, Guangzhou 510700, China.
authors.forename: Shu-Zhong
authors.initials: SZ
authors.lastname: Yao
keywords: Cervical cancer; Class I hysterectomy; Class III radical hysterectomy.; Oncological outcomes; Surgical outcomes