Primary therapy for early-stage cervical cancer: radical hysterectomy vs radiation

Nisha Bansal, Thomas J. Herzog, Richard E. Shaw, William M. Burke, Israel Deutsch, Jason D. Wright

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Objective: We compared survival for women with early-stage cervical cancer who were treated with primary radiation or radical hysterectomy. Study Design: Patients in the Surveillance, Epidemiology, and End Results database with stage IB1-IIA cervical cancer were examined. Radical hysterectomy was compared with primary combination external-beam and brachytherapy radiation. Results: A total of 4885 patients were identified. Multivariate analysis showed that radical hysterectomy was associated with a 59% reduction in mortality rate (hazard ratio, 0.41; 95% confidence interval [CI], 0.35-0.50). After stratification by tumor size, hysterectomy was associated with a 62% reduction in mortality rate (hazard ratio, 0.38; 95% CI, 0.30-0.48) for tumors that were <4 cm in diameter and a 49% improvement in survival (hazard ratio, 0.51; 95% CI, 0.36-0.72) for tumors that were 4-6 cm in diameter. Among women with tumors that were >6 cm in size, survival was equivalent between radical hysterectomy and radiation. Conclusion: Our data indicate that, in women with cervical cancer lesions of <6 cm, radical hysterectomy is superior to primary radiation.

Original languageEnglish (US)
Pages (from-to)485.e1-485.e9
JournalAmerican Journal of Obstetrics and Gynecology
Volume201
Issue number5
DOIs
StatePublished - Nov 2009
Externally publishedYes

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Hysterectomy
Uterine Cervical Neoplasms
Radiation
Therapeutics
Confidence Intervals
Survival
Mortality
Brachytherapy
Neoplasms
Epidemiology
Multivariate Analysis
Databases

Keywords

  • cervical cancer
  • radiation
  • radical hysterectomy
  • SEER

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Primary therapy for early-stage cervical cancer : radical hysterectomy vs radiation. / Bansal, Nisha; Herzog, Thomas J.; Shaw, Richard E.; Burke, William M.; Deutsch, Israel; Wright, Jason D.

In: American Journal of Obstetrics and Gynecology, Vol. 201, No. 5, 11.2009, p. 485.e1-485.e9.

Research output: Contribution to journalArticle

Bansal, Nisha ; Herzog, Thomas J. ; Shaw, Richard E. ; Burke, William M. ; Deutsch, Israel ; Wright, Jason D. / Primary therapy for early-stage cervical cancer : radical hysterectomy vs radiation. In: American Journal of Obstetrics and Gynecology. 2009 ; Vol. 201, No. 5. pp. 485.e1-485.e9.
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