Impact of Radical Hysterectomy on Survival in Patients with Stage 2 Type1 Endometrial Carcinoma: A Matched Cohort Study.

Abstract

In cases of stage 2 endometrial cancers (ECs), a radical hysterectomy is recommended; however, its benefits are poorly documented. The aim of this study was to determine whether a primary radical hysterectomy improves specific and overall survival compared with a simple hysterectomy in stage 2 EC. Data from all women with type 1 EC and International Federation of Gynecology and Obstetrics (FIGO) 2009 stage 2 who underwent surgical treatment between January 1998 and December 2012 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Women treated with radical hysterectomy were matched with women treated with simple hysterectomy according to demographic and tumoral criteria. The primary endpoint was cancer-related survival. One-to-two matching enabled a comparison of 273 patients who underwent a radical hysterectomy for stage 2 EC (case group) with 546 patients who received a simple hysterectomy (control group). The probability of cancer-related survival was not significantly different in the case group compared with the control group (p=0.08), and the 3-year cancer-related survivals in the radical and simple hysterectomy groups were 88.7 and 94.1%, respectively. Following adjustment for radiation, survival analysis indicated there was no survival difference between the two groups with regard to cancer-related survival or overall survival. The present study indicates that for patients with stromal cervical invasion and type 1 EC, the type of hysterectomy does not impact cancer-related or overall survival, even after adjustment for adjuvant radiation. This finding suggests that additional, randomized clinical studies are required.