BACKGROUND: Cervical cancer is the second most common cancer among women up to 65 years of age and is the most frequent cause of death from gynaecological cancers worldwide. Women with International Federation of Gynecology and Obstetrics (FIGO) stage IA2 cervical cancer have measured stromal invasion (when the cancer breaks through the basement membrane of the epithelium) of greater than 3 mm and no greater than 5 mm in depth with a horizontal surface extension of no more than 7 mm. For stage IA2 disease, radical hysterectomy with pelvic lymphadenectomy or radiotherapy is the standard treatment. In order to avoid complications of more radical surgical methods, less invasive options, such as simple hysterectomy, simple trachelectomy or conisation, with or without pelvic lymphadenectomy, may be feasible for stage IA2 disease, considering the relative low risk of local or distant metastatic disease. The evidence for less radical tumour excision and for the role of systematic lymphadenectomy in stage IA2 cervical cancer is not clear. OBJECTIVES: To evaluate the effectiveness and safety of less radical surgery in stage IA2 cervical cancer. SEARCH METHODS: We searched the Cochrane Gynaecological Cancer Group trials register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE up to September 2013. We also searched registers of clinical trials and abstracts of scientific meetings. SELECTION CRITERIA: We searched for randomised controlled trials (RCTs) that compared surgical techniques in women with stage IA2 cervical cancer. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed whether potentially relevant studies met the inclusion criteria. We found no trials and, therefore, no data were analysed. MAIN RESULTS: The search strategy identified 982 unique references, which were all excluded on the basis of title and abstract because it was clear that they did not meet the inclusion criteria. We identified one relevant large ongoing trial, so it is anticipated that we will be able to add this evidence to this review in the future. AUTHORS' CONCLUSIONS: We found no evidence to inform decisions about different surgical techniques in women with stage IA2 cervical cancer. In the future, the results of one large ongoing RCT should allow comparison of different types of surgery.
BACKGROUND: Cervical cancer is the second most common cancer among women up to 65 years of age and is the most frequent cause of death from gynaecological cancers worldwide. Women with International Federation of Gynecology and Obstetrics (FIGO) stage IA2 cervical cancer have measured stromal invasion (when the cancer breaks through the basement membrane of the epithelium) of greater than 3 mm and no greater than 5 mm in depth with a horizontal surface extension of no more than 7 mm. For stage IA2 disease, radical hysterectomy with pelvic lymphadenectomy or radiotherapy is the standard treatment. In order to avoid complications of more radical surgical methods, less invasive options, such as simple hysterectomy, simple trachelectomy or conisation, with or without pelvic lymphadenectomy, may be feasible for stage IA2 disease, considering the relative low risk of local or distant metastatic disease. The evidence for less radical tumour excision and for the role of systematic lymphadenectomy in stage IA2 cervical cancer is not clear. OBJECTIVES: To evaluate the effectiveness and safety of less radical surgery in stage IA2 cervical cancer. SEARCH METHODS: We searched the Cochrane Gynaecological Cancer Group trials register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE up to September 2013. We also searched registers of clinical trials and abstracts of scientific meetings. SELECTION CRITERIA: We searched for randomised controlled trials (RCTs) that compared surgical techniques in women with stage IA2 cervical cancer. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed whether potentially relevant studies met the inclusion criteria. We found no trials and, therefore, no data were analysed. MAIN RESULTS: The search strategy identified 982 unique references, which were all excluded on the basis of title and abstract because it was clear that they did not meet the inclusion criteria. We identified one relevant large ongoing trial, so it is anticipated that we will be able to add this evidence to this review in the future. AUTHORS' CONCLUSIONS: We found no evidence to inform decisions about different surgical techniques in women with stage IA2 cervical cancer. In the future, the results of one large ongoing RCT should allow comparison of different types of surgery.
Authors: László Ungár; László Pálfalvi; Russell Hogg; Pál Siklós; Deborah C M Boyle; Giuseppe Del Priore; J Richard Smith Journal: BJOG Date: 2005-03 Impact factor: 6.531
Authors: Jason D Wright; Thomas J Herzog; Alfred I Neugut; William M Burke; Yu-Shiang Lu; Sharyn N Lewin; Dawn L Hershman Journal: Gynecol Oncol Date: 2012-06-24 Impact factor: 5.482
Authors: Michael Frumovitz; Charlotte C Sun; Leslie R Schover; Mark F Munsell; Anuja Jhingran; J Taylor Wharton; Patricia Eifel; Therese B Bevers; Charles F Levenback; David M Gershenson; Diane C Bodurka Journal: J Clin Oncol Date: 2005-10-20 Impact factor: 44.544
Authors: P R Bhosale; R B Iyer; P Ramalingam; K M Schmeler; W Wei; R L Bassett; P T Ramirez; M Frumovitz Journal: Clin Radiol Date: 2016-03-21 Impact factor: 2.350
Authors: Rosa Drago-Ferrante; Riccardo Di Fiore; Fathi Karouia; Yashwanth Subbannayya; Saswati Das; Begum Aydogan Mathyk; Shehbeel Arif; Ana Paula Guevara-Cerdán; Allen Seylani; Aman Singh Galsinh; Weronika Kukulska; Joseph Borg; Sherif Suleiman; David Marshall Porterfield; Andrea Camera; Lane K Christenson; April Elizabeth Ronca; Jonathan G Steller; Afshin Beheshti; Jean Calleja-Agius Journal: Int J Mol Sci Date: 2022-07-05 Impact factor: 6.208