Morbidity of radical surgery and postoperative radiotherapy in cervical cancer Journal Article


Authors: Mora-Soto, N.; Morante-Caicedo, C.; Caicedo-Martinez, M.; Viveros-Carreno, D.; Diaz, E. S.; Rodriguez, J.; Vieira, S.; Peralta, J. A.; Abu-Rustum, N. R.; Pareja, R.
Article Title: Morbidity of radical surgery and postoperative radiotherapy in cervical cancer
Abstract: <p>Cervical cancer is among the most common cancers affecting women worldwide. The standard treatment for early-stage cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] 2018 stages IA1-IB2, IIA1) typically involves a radical or simple hysterectomy with lymph node assessment. Postoperative management may include observation or tailored adjuvant therapy, such as radiotherapy or chemoradiotherapy, depending on individual pathological risk factors. However, these interventions are associated with significant complications: surgical management can lead to urinary and sexual dysfunction, lymphocysts, and lower limb lymphedema, while radiotherapy may cause genitourinary, gastrointestinal, and sexual toxicities. Less-radical surgery for selected cases could reduce surgical morbidity and advances in radiotherapy techniques, such as intensity-modulated radiotherapy, volumetric modulated arc therapy, and other three-dimensional conformal radiation therapies, have the potential to enhance precision and reduce toxicity. Nonetheless, the morbidity associated with combining radical surgery and adjuvant (chemo)radiotherapy remains an area of uncertainty, particularly in light of these emerging technologies. Most current data on this topic derive from retrospective studies involving heterogeneous populations and inconsistent quality-of-life assessment methods. Prospective studies employing standardized morbidity assessment tools are essential to determine the true impact of combined treatments compared to single-modality approaches. Future research should prioritize understanding the long-term effects of these treatment strategies, aiming to minimize adverse outcomes while maintaining optimal oncological control.</p>
Keywords: hysterectomy; postoperative complications; lymphedema; sexual dysfunction; intensity-modulated radiotherapy; adjuvant radiotherapy; radical hysterectomy; cervical cancer; stage; quality-of-life; risk-factors; randomized-trial; concurrent chemotherapy; intensity-modulated radiation therapy (imrt); lower-extremity lymphedema; pelvic radiation-therapy; treatment morbidity
Journal Title: International Journal of Gynecology and Obstetrics
Volume: 171
ISSN: 0020-7292
Publisher: Wiley-Blackwell Publishing Ltd.  
Date Published: 2025-09-01
Start Page: 189
End Page: 198
Language: English
ACCESSION: WOS:001570254100007
DOI: 10.1002/ijgo.70281
PROVIDER: wos
Notes: Article -- SI -- 1 -- Source: Wos
Altmetric
Citation Impact
BMJ Impact Analytics