JAMA Netw Open

Less radical surgery may be just as effective for low-risk cervical cancer

May 27, 2025

Study details: This retrospective cohort study analyzed 2,636 women with FIGO 2009 stage IA2 or IB1 (≤2 cm) squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma of the cervix and clinically negative lymph nodes, treated at U.S. Commission on Cancer-accredited facilities from 2010–2017. Patients underwent simple hysterectomy (SH, n = 982), modified radical hysterectomy (MRH, n = 300), or radical hysterectomy (RH, n = 927), with survival as the primary endpoint.

Results: Long-term survival was similar across surgical groups. The 7-year survival rate was 93.9% (SH) vs. 95.3% (MRH/RH), with no statistically significant difference (P = 0.07). Adjusted hazard ratios for death didn't differ between SH and more radical procedures, and survival remained consistent across subgroups (age, comorbidity, histology, surgical approach). Propensity score–adjusted 10-year survival was 89.8% (SH) vs. 91.7% (MRH/RH).

Clinical impact: These findings support the use of simple hysterectomy as an oncologically safe option for appropriately selected patients with low-risk, early-stage cervical cancer, potentially reducing surgical morbidity without compromising long-term survival.

Source:

Tarney CM, et al. (2025, May 1). JAMA Netw Open. Long-Term Survival in Patients With Low-Risk Cervical Cancer After Simple, Modified, or Radical Hysterectomy. https://pubmed.ncbi.nlm.nih.gov/40372751/