American Journal of Obstetrics & Gynecology
Volume 201, Issue 5 , Pages 485.e1-485.e9 , November 2009

Primary therapy for early-stage cervical cancer: radical hysterectomy vs radiation

  • Nisha Bansal, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY
  • ,
  • Thomas J. Herzog, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY
  • ,
  • Richard E. Shaw, PhD

      Affiliations

    • California Pacific Medical Center, San Francisco, CA
  • ,
  • William M. Burke, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY
  • ,
  • Israel Deutsch, MD

      Affiliations

    • Department of Radiation Oncology, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY
  • ,
  • Jason D. Wright, MD

      Affiliations

    • Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY
    • Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY
    • Corresponding Author InformationReprints: Jason D. Wright, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Ave., 8th Floor, New York, NY 10032

Received 6 April 2009 ,Revised 18 May 2009 ,Accepted 5 June 2009.

References 

  1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71–96
  2. Monk BJ, Tewari KS, Koh WJ. Multimodality therapy for locally advanced cervical carcinoma: state of the art and future directions. J Clin Oncol. 2007;25:2952–2965
  3. Gray HJ. Primary management of early stage cervical cancer (IA1-IB) and appropriate selection of adjuvant therapy. J Natl Compr Canc Netw. 2008;6:47–52
  4. Landoni F, Maneo A, Colombo A, et al. Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet. 1997;350:535–540
  5. Newton M, Hickman BT, Bolten KA. Radical hysterectomy versus radiotherapy in stage I cervical cancer: preliminary results. Obstet Gynecol. 1964;24:563–568
  6. Morley GW, Seski JC. Radical pelvic surgery versus radiation therapy for stage I carcinoma of the cervix (exclusive of microinvasion). Am J Obstet Gynecol. 1976;126:785–798
  7. Newton M. Radical hysterectomy or radiotherapy for stage I cervical cancer: a prospective comparison with 5 and 10 years follow-up. Am J Obstet Gynecol. 1975;123:535–542
  8. Surveillance, Epidemiology, and End Results SEER*Stat Database: Incidence-SEER 9 Regs Limited-Use, Nov 2006 Sub (1973-2004), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2007, based on the November 2006 submission. http://.seer.cancer.govAccessed Oct. 1, 2007.
  9. The Surveillance, Epidemiology, and End Results (SEER) program, data quality (National Cancer Institute). http://seer.cancer.gov/about/2007;Accessed Oct. 1, 2007.
  10. Jewell EL, Kulasingam S, Myers ER, Alvarez Secord A, Havrilesky LJ. Primary surgery versus chemoradiation in the treatment of IB2 cervical carcinoma: a cost effectiveness analysis. Gynecol Oncol. 2007;107:532–540
  11. Yessaian A, Magistris A, Burger RA, Monk BJ. Radical hysterectomy followed by tailored postoperative therapy in the treatment of stage IB2 cervical cancer: feasibility and indications for adjuvant therapy. Gynecol Oncol. 2004;94:61–66
  12. Rutledge TL, Kamelle SA, Tillmanns TD, et al. A comparison of stages IB1 and IB2 cervical cancers treated with radical hysterectomy (Is size the real difference?). Gynecol Oncol. 2004;95:70–76
  13. Sedlis A, Bundy BN, Rotman MZ, Lentz SS, Muderspach LI, Zaino RJ. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: a Gynecologic Oncology Group study. Gynecol Oncol. 1999;73:177–183
  14. Rotman M, Sedlis A, Piedmonte MR, et al. A phase III randomized trial of postoperative pelvic irradiation in stage IB cervical carcinoma with poor prognostic features: follow-up of a gynecologic oncology group study. Int J Radiat Oncol Biol Phys. 2006;65:169–176
  15. Peters WA, Liu PY, Barrett RJ, et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol. 2000;18:1606–1613
  16. Cosin JA, Fowler JM, Chen MD, Paley PJ, Carson LF, Twiggs LB. Pretreatment surgical staging of patients with cervical carcinoma: the case for lymph node debulking. Cancer. 1998;82:2241–2248
  17. Low JA, Mauger GM, Carmichael JA. The effect of Wertheim hysterectomy upon bladder and urethral function. Am J Obstet Gynecol. 1981;139:826–834
  18. Kadar N, Saliba N, Nelson JH. The frequency, causes and prevention of severe urinary dysfunction after radical hysterectomy. BJOG. 1983;90:858–863
  19. Photopulos GJ, Zwaag RV. Class II radical hysterectomy shows less morbidity and good treatment efficacy compared to class III. Gynecol Oncol. 1991;40:21–24
  20. Sartori E, Fallo L, La Face B, Bianchi UA, Pecorelli S. Extended radical hysterectomy in early-stage carcinoma of the uterine cervix: tailoring the radicality. Int J Gynecol Cancer. 1995;5:143–147
  21. Frumovitz M, Sun CC, Schover LR, et al. Quality of life and sexual functioning in cervical cancer survivors. J Clin Oncol. 2005;23:7428–7436
  22. Covens A, Rosen B, Murphy J, et al. Changes in the demographics and perioperative care of stage IA(2)/IB(1) cervical cancer over the past 16 years. Gynecol Oncol. 2001;81:133–137
  23. Esthappan J, Chaudhari S, Santanam L, et al. Prospective clinical trial of positron emission tomography/computed tomography image-guided intensity-modulated radiation therapy for cervical carcinoma with positive para-aortic lymph nodes. Int J Radiat Oncol Biol Phys. 2008;72:1134–1139
  24. Pellegrino A, Vizza E, Fruscio R, et al. Total laparoscopic radical hysterectomy and pelvic lymphadenectomy in patients with Ib1 stage cervical cancer: analysis of surgical and oncological outcome. Eur J Surg Oncol. 2009;35:98–103
  25. Patel DA, Barnholtz-Sloan JS, Patel MK, Malone JM, Chuba PJ, Schwartz K. A population-based study of racial and ethnic differences in survival among women with invasive cervical cancer: analysis of Surveillance, Epidemiology, and End Results data. Gynecol Oncol. 2005;97:550–558
  26. Brooks SE, Chen TT, Ghosh A, Mullins CD, Gardner JF, Baquet CR. Cervical cancer outcomes analysis: impact of age, race, and comorbid illness on hospitalizations for invasive carcinoma of the cervix. Gynecol Oncol. 2000;79:107–115
  27. Wright JD, Gibb RK, Geevarghese S, et al. Cervical carcinoma in the elderly: an analysis of patterns of care and outcome. Cancer. 2005;103:85–91
  28. de Rijke JM, van der Putten HW, Lutgens LC, et al. Age-specific differences in treatment and survival of patients with cervical cancer in the southeast of The Netherlands, 1986-1996. Eur J Cancer. 2002;38:2041–2047
  29. Morris M, Eifel PJ, Lu J, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med. 1999;340:1137–1143

 Cite this article as: Bansal N, Herzog TJ, Shaw RE, et al. Primary therapy for early-stage cervical cancer: radical hysterectomy vs radiation. Am J Obstet Gynecol 2009;201:485.e1-9.

 Authorship and contribution to the article is limited to the 6 authors indicated. There was no outside funding or technical assistance with the production of this article.

PII: S0002-9378(09)00637-1

doi: 10.1016/j.ajog.2009.06.015

American Journal of Obstetrics & Gynecology
Volume 201, Issue 5 , Pages 485.e1-485.e9 , November 2009