A simple hysterectomy, a surgical procedure in which the uterus and cervix are removed, is a safe treatment option that can improve quality of life for women with early-stage, low-risk cervical cancer, according to the results of a phase III clinical trial.
Studies have shown that a simple hysterectomy has similar results in keeping them cancer-free, compared to a standard radical hysterectomy, which removes the uterus, cervix, upper part of the vagina and other nearby tissue.
Because radical hysterectomy is a more complex surgery, it is associated with more acute and long-term side effects, as well as potential effects on patients’ quality of life and sexual health.
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“Sexual health and quality of life are very important considerations for cancer patients,” said Dr. Lori Broteau, professor of obstetrics and gynecology at the University of British Columbia.
“The results of this study indicate that patients can expect less negative impact on sexual health and many other aspects of quality of life with simple hysterectomy while not compromising the impact on recurrence and survival rates,” Brotto added.
The study looked at three-year pelvic recurrence rates and other health outcomes in 700 patients from 12 countries who underwent both simple and radical hysterectomy.
Results presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting showed that extra-pelvic recurrence-free survival, relapse-free survival and overall survival were comparable between the two groups.
The general hysterectomy group had fewer intraoperative urological surgical complications and fewer immediate and long-term bladder problems. Several quality aspects of life, such as body image, pain and sexual health, were consistently more favorable among them.
“These results are important because they show, for the first time, that a simple hysterectomy is a safe option for women with carefully selected early-stage low-risk cervical cancer,” said Dr. Marie Plante, head of the study and a gynecologic oncologist at Université Laval in Quebec.
“This trial will likely be a practice-changing, new standard-of-care treatment for patients with low-risk disease with a simple hysterectomy rather than a radical hysterectomy.”
Globally, cervical cancer is the fourth most commonly diagnosed cancer and the fourth most common cause of cancer death in women. About 44 percent of women with cervical cancer are diagnosed at an early stage, with a significant proportion meeting low-risk criteria, according to the team. If detected at an early stage, the 5-year relative survival rate for invasive cervical cancer is 92 percent.
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