Comparison of the Outcomes of Simple versus Radical Hysterectomy in Elderly Patients with Cervical Cancer
10.3760/cma.j.issn.0254-9026.2025.04.016
- VernacularTitle:老年宫颈癌患者行单纯或根治性子宫切除术效果比较
- Author:
Liangxue HOU
1
;
Ying ZHAO
;
Yanhua CAO
;
Hui WANG
;
Xiaomeng WANG
Author Information
1. 商丘市第一人民医院肿瘤放疗科，商丘 476100
- Publication Type:Journal Article
- Keywords:
Low-risk cervical cancer;
Simple hysterectomy;
Radical hysterectomy;
Elderly patients;
Pelvic recurrence rate
- From:
Chinese Journal of Geriatrics
2025;44(4):504-509
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the outcomes of simple hysterectomy(SH)and radical hysterectomy(RH)in elderly patients with cervical cancer.Methods:A retrospective cohort study was conducted, including 633 elderly patients with cervical cancer who underwent surgical treatment at Shangqiu First People's Hospital from January 2016 to December 2020.Among them, 247 patients underwent SH, and 215 patients underwent RH.Propensity score matching was applied, resulting in two groups: 125 patients in the SH group and 124 patients in the RH group.The primary outcome was the pelvic recurrence rate at 2 years of follow-up.Secondary outcomes included the incidence of urinary incontinence and urinary retention.Kaplan-Meier survival analysis was used to compare the recurrence rates between the two groups, and a Cox proportional hazards regression model was used to analyze the factors influencing recurrence rates.Results:After matching, the baseline characteristics of the two groups were similar and comparable(all P>0.05).Kaplan-Meier results showed that, although the pelvic recurrence rate in the SH group was higher than that in the RH group before matching(4.5% vs.2.3%, P<0.05), the pelvic recurrence rates were similar between the two groups after matching(3.2% vs.2.4%, P>0.05).The SH group had significantly lower postoperative complications, including urinary retention(1.6% vs.8.1%, P<0.05), compared to the RH group, while there was no significant difference in the incidence of urinary incontinence(4.0% vs.9.7%)and the risk of cervical cancer-related death(1.6% vs.0.8%)between the two groups( P>0.05).Multivariate Cox regression analysis showed that age( HR=1.254), tumor grade( HR=1.315), and FIGO stage( HR=1.203)were important factors influencing pelvic tumor recurrence during follow-up(all P<0.05). Conclusions:elderly patients with low-risk cervical cancer, the 2-year pelvic recurrence rates for SH and RH are similar.However, SH is associated with a lower risk of urinary incontinence and urinary retention.
