New treatment shows promise for some women with cervical cancer

TORONTO: A simple hysterectomy, a surgical procedure where the uterus and cervix is removed, is a safe treatment option that can improve quality of life for women with early-stage, low-risk cervical cancer, according to results from the phase III clinical trial.

The study states that a simple hysterectomy resulted in similar outcomes in terms of keeping them cancer-free, compared to the standard radical hysterectomy, which removes the uterus, cervix, upper parts of the vagina and other nearby tissues.

Because radical hysterectomy is a more complex surgery, it is associated with more acute and long-term side effects, as well as potential impacts on quality of life and sexual health for patients.

"Sexual health and quality of life are very important considerations for patients undergoing cancer treatment," said Dr. Lori Brotto, a professor of obstetrics and gynaecology at University of British Columbia.

"The findings from this study indicate that patients can expect fewer negative effects on sexual health and many other facets of quality of life with simple hysterectomy while not compromising effects on recurrence and survival rates," Brotto added.

The study looked at the three-year pelvic recurrence rate and other health outcomes in 700 patients from 12 countries receiving both simple and radical hysterectomies.

The findings, presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting, showed that the extra-pelvic recurrence-free survival, the relapse-free survival, and the overall survival were comparable between the two groups.

There were fewer intraoperative urological surgical complications and fewer immediate and long-term bladder problems in the simple hysterectomy group.

Several quality-of-life aspects, such as body image, pain, and sexual health, were consistently more favourable in them.

"These results are important because it demonstrates, for the first time, that a simple hysterectomy is a safe option for women with carefully selected early-stage low-risk cervical cancer," said Dr. Marie Plante, the study lead and a gynecologic oncologist at Universite Laval in Quebec.

"This trial will likely be practice-changing, with the new standard-of-care treatment for patients with low-risk disease being a simple hysterectomy instead of radical hysterectomy."

Worldwide, cervical cancer is the fourth most diagnosed cancer and fourth most common cause of cancer death in women.

About 44 per cent of women with cervical cancer are diagnosed with early-stage disease, of which a significant proportion will meet low-risk criteria, according to the team.

When detected at an early stage, the 5-year relative survival rate for invasive cervical cancer is 92 per cent.