New approach to cervical cancer treatment: comparing simple and radical hysterectomy

Cervical cancer remains a significant health concern, affecting millions of women each year. In this context, treatments for low-risk cervical cancer are gaining increasing interest.

Despite an elevated risk of complications, radical hysterectomy, which involves the removal of the uterus, cervix, and surrounding tissues, is the current standard for treating early-stage cervical cancer. However, recent data suggest that simple hysterectomy, which only removes the uterus and cervix, could be a safe and effective alternative for women with low-risk cervical cancer.

This study was thus initiated to evaluate the efficacy and safety of simple hysterectomy compared to radical hysterectomy in women with low-risk cervical cancer.

Simple vs. radical hysterectomy: similar efficacy for low-risk cervical cancer?

The SHAPE study is a phase 3, randomized, multicenter clinical trial conducted on 700 women with low-risk cervical cancer, classified as stage IA or IB according to the FIGO 2009 classification. The inclusion criteria are as follows:

• FIGO stage IA2 or IB1 with a tumor ≤ 2 cm;
• Limited stromal invasion (<10 mm);
• No lymph node metastasis.

To compare the effectiveness of the two treatments, patients were randomly assigned to one of two groups: treatment by simple hysterectomy or by radical hysterectomy. The primary endpoint was pelvic cancer recurrence within three years.

The results, observed after a median follow-up of 4.5 years, show a pelvic recurrence rate at three years of 2.52% for simple hysterectomy and 2.17% for radical hysterectomy, confirming similar efficacy for both treatments. Additionally, the analysis revealed a lower rate of urinary incontinence for simple hysterectomy compared to the radical method (2.4% versus 5.5% within the first four weeks post-operation).

Simple hysterectomy: a promising alternative for low-risk cervical cancer treatment

This study demonstrates that simple hysterectomy is a non-inferior alternative to radical hysterectomy for patients with low-risk cervical cancer, reducing adverse effects while maintaining similar survival rates, thereby offering patients an improved quality of life. These promising results suggest that this less invasive approach could become the standard for managing such cases. However, ongoing recurrence monitoring and further studies are essential to confirm the long-term sustainability of this method.