Machida H, et al. - Reproductive-aged women who underwent trachelectomy for early-stage cervical cancer were compared to those who had hysterectomy in terms of characteristics and survival. Findings suggest a significant increase in the proportion of reproductive-aged women with stage IA or IB1 (≤ 2cm) cervical cancer who underwent trachelectomy in recent years. In this population, trachelectomy led to survival outcomes comparable to those who had hysterectomy.

Methods

• Between 1998 and 2014, researchers performed a retrospective observational study examining the Surveillance, Epidemiology, and End Results Program.
• They compared women less than 45 years of age with stage IA and IB1 (tumor size ≤2 cm) cervical cancer who underwent trachelectomy vs those who underwent hysterectomy.
• Clinico-pathological factors associated with trachelectomy were identified using multivariable models.
• The two groups were compared regarding survival after propensity score matching.

Results

• Researchers recruited 6,359 women in this study; of these, 190 (3.0%, 95% confidence interval [CI] 2.6-3.4) underwent trachelectomy.
• The trachelectomy group had the median age of 31 years (inter-quartile range, 28-34).
• During the study period, a significant increase in the proportion of women who underwent trachelectomy was noted (1.2% in 1998-2002, 3.0% in 2003-2008, and 4.5% in 2009-2014, P < 0.001).
• Independent factors associated with trachelectomy use included younger age, non-black race, single marital status, Eastern registry area, recent disease diagnosis, non-squamous histology, and higher stage (all, adjusted-P < 0.05).
• The trachelectomy group and the hysterectomy group were similar in terms of 5-year cause-specific survival (96.9% vs 96.6%, hazard ratio 0.73, 95% CI 0.23-2.30, P=0.59) and overall survival (96.1% vs 96.6%, hazard ratio 0.76, 95% CI 0.26-2.20, P=0.61) after propensity score matching.