Lymphadenectomy alone is a feasible option in managing incidentally- detected early-stage cervical cancer after simple hysterectomy without intermediate-risk factors: An application of the concept of less radical surgery

摘要

Aim: To assess the feasibility of less radical surgery in patients with incidentally-detected cervical cancer at simple hysterectomy. Patients and Methods: High-risk factors (HFs) were evaluated in 104 patients who underwent radical hysterectomy and lymphadenectomy for the treatment of stage IA1-IB1 cervical cancer according to intermediate-risk factors (IFs). Results: Thirty-three patients without IFs had no HFs. As the number of IFs increased, the number of HFs increased (p=0.009). Multivariate analysis revealed that lymph node metastasis was the only independent risk factor for parametrial involvement (hazard ratio, 31.3; 95% confidence interval, 1.6-599.4; p=0.022). An absence of IFs was associated with a longer progression-free survival than the presence of IFs in the subgroup analysis of favorable histologies (p=0.044). Conclusion: HFs could be excluded in stage IA1-IB1 cervical cancer without IFs. Omitting parametrectomy seems a feasible option for selected patients with incidentally-detected early-stage cervical cancer at simple hysterectomy, without IFs.