[Is radical hysterectomy necessary in surgical procedure for early stage cervical cancer?]

Abstract

Objective: Radical hysterectomy is one of the treatment options for early stage cervical cancer. This surgery results in significant morbidity, especially urinary complications. The objective of the study is to determine the rate and predictive factors of parametrial involvement in early stage cervical cancer and to define a subset of patient at low risk for parametrial disease and potential applicant to less morbid surgery.

Methods: This review reports recent retrospective and prospective studies and we show randomized trial concerning feasibility of no radical surgery.

Results: Parametrial involvement rate in tumors <2 cm, without lymphovascular space invasion, with negative lymph nodes and depth of invasion <10mm is between 0 and 1.96%.

Conclusion: This result, which suggests simple hysterectomy, is maybe adequate in this case. At present, no randomized trial allows to validate this hypothesis and to change present practices. Radical hysterectomy stays standard of surgical treatment of early stage cervical cancer.

Keywords: Cancer du col précoce; Chirurgie moins radicale; Early stage cervical cancer; Invasion paramétriale; Less radical surgery; Parametrial involvement.