CHICAGO — When it comes to preventing pelvic recurrence in low-risk cervical cancer, simple hysterectomy is not inferior to radical hysterectomy, according to results from a phase 3, randomized, controlled trial.
Retrospective studies found that infiltration of the parametrium is quite rare in low-risk cases,"suggesting that less radical surgery may be a safe option associated with decreased morbidity – what we call surgical de-escalation," said Dr. Plante. There were no statistically significant differences in intraoperative complications or mortality between the groups.There were some differences between the groups with respect to surgery-related adverse events. Within 4 weeks of surgery, there was a greater incidence of any adverse event in the radical hysterectomy group , as well as greater incidences of urinary incontinence and urinary retention .
"Amongst those carefully selected tumors, radical hysterectomy can be converted to a simple hysterectomy, including minimally invasive. You still have to do nodes – that's an important thing to remember — but you can do this without loss of oncologic control. And importantly, with reduction in surgical complications, postop morbidity, specifically neurologic morbidity.
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