Abstract
The presentation of the results of the prospective randomized international multicenter
study AGO-OP.8 – CCTG CX.5 – SHAPE at the annual conference of the American Society
of Clinical
Oncology (ASCO) in 2023 will affect the surgical treatment of early-stage cervical
cancer. In the SHAPE study, simple total hysterectomy (experimental arm) was found
to be non-inferior to
radical hysterectomy (standard arm) to treat patients with early-stage cervical cancer
(FIGO stages [2018] IA2 – IB1 ≤ 2 cm with an infiltration depth of < 1 cm); after
3 yearsʼ follow-up
the pelvic recurrence rate was 2.52% (experimental arm) compared to 2.17% (standard
arm) with no statistically significant difference with regards to recurrence-free
survival and overall
survival rates. After weighing up the results of the SHAPE study published at the
conference, the Uterus Organ Commission of AGO is of the opinion that, in addition
to the use of radical
hysterectomy to treat patients with invasive cervical cancer which is FIGO stage IA2
– IB1 ≤ 2 cm with an infiltration depth of < 1 cm, simple total hysterectomy may also
be considered
for primary surgical therapy on a case-by-case basis after suitable explanation of
the associated risks. It will be necessary to wait for the data of the full publication
before discussing
whether this approach should be included in official guidelines and defining it as
a new therapy standard.
Key words cervical cancer - radical hysterectomy - early-stage - simple hysterectomy
