Radical or Modified Radical Hysterectomy does not benefit the Prognosis of Patients with StageⅡendometrial Cancer

Abstract

Background: Although total hysterectomy (TH)/ radical hysterectomy (RH) + double appendectomy + staging surgery is recommended for patients with stageⅡndometrial cancer (EC), gynecologists disagree on whether to choose TH or RH/ modified radical hysterectomy (mRH) in practice. This study aims to explore whether TH or RH/mRH affect the prognosis of patients with EC.Materials and Methods: 808 stageⅡEC patients who underwent surgery were included in the retrospective analysis. The patients were grouped according to the surgical method (TH, n=434, RH/mRH, n=374) and clinical characteristics were collected. Kaplan-Meier method was used for survival analysis, and P values were calculated by log-rank test. Prognostic analysis was performed by Cox proportional hazards regression models.Results: Patients underwent RH/mRH had worse progression-free survival (PFS) (HR=2.235, 95%CI= 1.159-4.31, P=0.016), TH or RH/mRH does not affect the overall survival (OS) of patients (HR=1.511, 95%CI=0.802-2.845, P=0.201). Postoperative adjuvant therapy will improve PFS (HR=2.209, 95%CI=1.091-4.472, P=0.028). In patients received postoperative adjuvant therapy, RH/mRH is the independent risk factor of PFS (HR=2.328, 95%CI= 1.042-5.203, P=0.039). Neither PFS nor OS are affected by the type of hysterectomy in patients without adjuvant therapy. In addition, the operation time of RH/mRH is longer than that of TH. Conclusion: RH/mRH will not improve PFS and OS in patients with clinical stageⅡEC, but will increase the length of surgery. In clinical treatment, there is no need for gynecologists to implement RH/mRH for patients with stageⅡEC.