ArticleBMC surgery2025
The potential for de-escalation radical surgery in women with stage IB2 cervical cancer (FIGO 2018): a multi-institutional experience of 63,926 cases over a 14-year period in China.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo compare the long-term survival outcomes, recurrence patterns and morbidity of type B and type C radical hysterectomy (RH) for stage IB2 cervical cancer (FIGO 2018).
methodsBased on FOUR-C database, patients who underwent type B or C RH in 47 hospitals from 2004 to 2018 were reviewed. Univariate and multivariate analyses were performed to compare 5-year overall survival (OS) and recurrence-free survival (RFS), recurrence patterns and morbidity between the two groups after propensity score matching (PSM).
resultsA total of 1308 patients were enrolled in this study, 840 and 468 patients underwent type B and type C. There was no difference in 5-year survival outcomes between groups type B and type C, either before or after matching (OS: unmatched 95.6% vs. 93.3%, matched 95.6 vs. 93.0%, P>0.05; RFS: unmatched: 90.5% vs. 90.1%, matched: 91.2% vs. 89.7%, P>0.05). Type B group had a shorter operative time, less blood loss, earlier recovery of intestinal function, eariler removal of catheter and shorter hospitalization (P<0.01). Intraoperative complications were similar (0.1% vs. 0.2%, P>0.05), but postoperative complications occurred more frequently in the type C group (8.3% vs. 12.1%, P < 0.05), especially lymphocysts and urinary retention. The surgical dissection does not appear to influence tumor recurrences significantly (P>0.05).
conclusionsFor cervical cancer patients with stage IB2, type B RH demonstrated comparable long-term oncological outcomes and recurrence patterns to type C RH, while being associated with fewer intra-and postoperative complications. Type B RH is a feasible and appropriate surgical option, but the conclusions need to be confirmed by prospective studies.
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