What is the impact of radical hysterectomy on endometrial cancer with cervical involvement?

Abstract

Background When endometrial carcinoma invades the cervical stroma, overall survival and disease-free survival decrease. However, it is still controversial whether patients in suspected stage II should be treated with radical hysterectomy. The goal of this study is to describe the role of radical hysterectomy in patients with endometrial carcinoma and cervical involvement. Methods This was a retrospective cohort study were a total of 239 patients with endometrial carcinoma with cervical involvement from Mexico City’s National Cancer Institute were divided according to the type of hysterectomy, and the outcomes were compared using statistical analysis. Results The 5-year overall survival was 75.76% for the simple hysterectomy group and 89.19% for the radical hysterectomy group, without achieving statistical significance. The 5-year disease-free survival was 72.95% for the simple hysterectomy group and 64.31% for the radical hysterectomy group, without achieving statistical significance. Radicality was associated with longer surgical times, intraoperative complications, and bleeding over 500 ml. Conclusions In patients with endometrial carcinoma with cervical involvement, radical hysterectomy does not improve prognosis or alter adjuvant therapy.

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

“…Japanese researchers believe that even if the tumor has invaded the cervix, RH is not necessary because it can improve the prognosis and lead to more perioperative and postoperative adverse events [11]. A North American study also discouraged RH for patients with stage EC because RH does not improve the patients' prognosis [12,13]. The results of this study indicate that neither PFS nor OS can be improved by RH/mRH and that PFS is worse in patients who undergo RH/mRH.…”

OS and DFS are affected by different diagnostic methods and hysterectomy procedures in endometrial cancer patients: A single‐center retrospective study

“…However, several clinical studies have reported contradictory results. 27,33 The type of hysterectomy was not identified as a prognostic factor in 180 EC patients; no survival benefits from RH were found and the procedure was more frequently associated with perioperative and urinary complications. 34 Phelippeau et al evaluated 7552 patients with stage II disease and found that the type of hysterectomy (RH) did not impact OS, even after adjusting for adjuvant radiation in a matched cohort study.…”

“…However, several clinical studies have reported contradictory results 27,33 . The type of hysterectomy was not identified as a prognostic factor in 180 EC patients; no survival benefits from RH were found and the procedure was more frequently associated with perioperative and urinary complications 34 .…”

Type and approach of hysterectomy and oncological survival of women with stage II cancer of endometrium: a large retrospective cohort study

“…The necessity of radical hysterectomy for women with FIGO 2009 stage II cancer of the endometrium has been controversial. Part of the published study has shown that the type of hysterectomy (radical hysterectomy versus simple hysterectomy) is not associated with the risk of disease recurrence and all-cause death in women with stage II cancer of the endometrium ( 14 – 16 , 26 – 28 ). However, there are also different viewpoints.…”

“…So we have this question: is a minimally invasive approach safe for stage II cancer of the endometrium which is also cervical involvement? In addition, in the treatment of stage II cancer of the endometrium, whether radical hysterectomy is oncologically superior to simple hysterectomy has not been determined ( 14 – 17 ).…”