Primary therapy for early-stage cervical cancer: radical hysterectomy vs radiation
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 comp...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 2009-11, Vol.201 (5), p.485.e1-485.e9 |
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| container_title | American journal of obstetrics and gynecology |
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| creator | Bansal, Nisha, MD Herzog, Thomas J., MD Shaw, Richard E., PhD Burke, William M., MD Deutsch, Israel, MD Wright, Jason D., MD |
| description | 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 6 cm in size, survival was equivalent between radical hysterectomy and radiation. Conclusion Our data indicate that, in women with cervical cancer lesions of |
| doi_str_mv | 10.1016/j.ajog.2009.06.015 |
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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.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/j.ajog.2009.06.015</identifier><identifier>PMID: 19879394</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Brachytherapy ; cervical cancer ; Female ; Female genital diseases ; Gynecology. Andrology. Obstetrics ; Humans ; Hysterectomy - methods ; Medical sciences ; Middle Aged ; Obstetrics and Gynecology ; radiation ; radical hysterectomy ; SEER ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the genital tract and mammary gland ; Survival Rate ; Tumors ; Uterine Cervical Neoplasms - mortality ; Uterine Cervical Neoplasms - radiotherapy ; Uterine Cervical Neoplasms - surgery</subject><ispartof>American journal of obstetrics and gynecology, 2009-11, Vol.201 (5), p.485.e1-485.e9</ispartof><rights>Mosby, Inc.</rights><rights>2009 Mosby, Inc.</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-a118d0a34b350556949acd371cdbe867404cf2e97706833850d974e5b6fb4c483</citedby><cites>FETCH-LOGICAL-c440t-a118d0a34b350556949acd371cdbe867404cf2e97706833850d974e5b6fb4c483</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002937809006371$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22114160$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19879394$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bansal, Nisha, MD</creatorcontrib><creatorcontrib>Herzog, Thomas J., MD</creatorcontrib><creatorcontrib>Shaw, Richard E., PhD</creatorcontrib><creatorcontrib>Burke, William M., MD</creatorcontrib><creatorcontrib>Deutsch, Israel, MD</creatorcontrib><creatorcontrib>Wright, Jason D., MD</creatorcontrib><title>Primary therapy for early-stage cervical cancer: radical hysterectomy vs radiation</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>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.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Brachytherapy</subject><subject>cervical cancer</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Hysterectomy - methods</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Obstetrics and Gynecology</subject><subject>radiation</subject><subject>radical hysterectomy</subject><subject>SEER</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the genital tract and mammary gland</subject><subject>Survival Rate</subject><subject>Tumors</subject><subject>Uterine Cervical Neoplasms - mortality</subject><subject>Uterine Cervical Neoplasms - radiotherapy</subject><subject>Uterine Cervical Neoplasms - surgery</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kV2L1DAUhoMo7rj6B7yQ3ohXrScfTRoRQRY_FhZW_LgOaXq6m9ppxqQz0H9vujMo7MVeJSc853DyvIS8pFBRoPLtUNkh3FQMQFcgK6D1I7KhoFUpG9k8JhsAYKXmqjkjz1Ia1pJp9pScUd0ozbXYkO_fot_auBTzLUa7W4o-xAJtHJcyzfYGC4fx4J0dC2enfH9XRNvd1bdLmjGim8N2KQ7p7t3OPkzPyZPejglfnM5z8uvzp58XX8ur6y-XFx-vSicEzKWltOnActHyGupaaqGt67iirmuxkUqAcD1DrRTIhvOmhk4rgXUr-1Y40fBz8uY4dxfDnz2m2Wx9cjiOdsKwT0ZxQWmtqcwkO5IuhpQi9mZ3_LWhYFaVZjCrSrOqNCBNVpmbXp3G79stdv9bTu4y8PoE2JSF9DEL8ukfxxilgkrI3Psjh1nGwWM0yXnMMju_6jNd8A_v8eFeuxv9tEbwGxdMQ9jHKWs21CRmwPxYU14zBw0gs07-F_r5pmo</recordid><startdate>20091101</startdate><enddate>20091101</enddate><creator>Bansal, Nisha, MD</creator><creator>Herzog, Thomas J., MD</creator><creator>Shaw, Richard E., PhD</creator><creator>Burke, William M., MD</creator><creator>Deutsch, Israel, MD</creator><creator>Wright, Jason D., MD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20091101</creationdate><title>Primary therapy for early-stage cervical cancer: radical hysterectomy vs radiation</title><author>Bansal, Nisha, MD ; Herzog, Thomas J., MD ; Shaw, Richard E., PhD ; Burke, William M., MD ; Deutsch, Israel, MD ; Wright, Jason D., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-a118d0a34b350556949acd371cdbe867404cf2e97706833850d974e5b6fb4c483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Brachytherapy</topic><topic>cervical cancer</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Hysterectomy - methods</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Obstetrics and Gynecology</topic><topic>radiation</topic><topic>radical hysterectomy</topic><topic>SEER</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the genital tract and mammary gland</topic><topic>Survival Rate</topic><topic>Tumors</topic><topic>Uterine Cervical Neoplasms - mortality</topic><topic>Uterine Cervical Neoplasms - radiotherapy</topic><topic>Uterine Cervical Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bansal, Nisha, MD</creatorcontrib><creatorcontrib>Herzog, Thomas J., MD</creatorcontrib><creatorcontrib>Shaw, Richard E., PhD</creatorcontrib><creatorcontrib>Burke, William M., MD</creatorcontrib><creatorcontrib>Deutsch, Israel, MD</creatorcontrib><creatorcontrib>Wright, Jason D., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bansal, Nisha, MD</au><au>Herzog, Thomas J., MD</au><au>Shaw, Richard E., PhD</au><au>Burke, William M., MD</au><au>Deutsch, Israel, MD</au><au>Wright, Jason D., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Primary therapy for early-stage cervical cancer: radical hysterectomy vs radiation</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2009-11-01</date><risdate>2009</risdate><volume>201</volume><issue>5</issue><spage>485.e1</spage><epage>485.e9</epage><pages>485.e1-485.e9</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><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.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>19879394</pmid><doi>10.1016/j.ajog.2009.06.015</doi><tpages>3</tpages></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Brachytherapy cervical cancer Female Female genital diseases Gynecology. Andrology. Obstetrics Humans Hysterectomy - methods Medical sciences Middle Aged Obstetrics and Gynecology radiation radical hysterectomy SEER Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the genital tract and mammary gland Survival Rate Tumors Uterine Cervical Neoplasms - mortality Uterine Cervical Neoplasms - radiotherapy Uterine Cervical Neoplasms - surgery |
| title | Primary therapy for early-stage cervical cancer: radical hysterectomy vs radiation |
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