Annals of Surgical Oncology

, Volume 19, Issue 2, pp 605–611 | Cite as

Comparison of Survival and Adverse Events between Women with Stage IB1 and Stage IB2 Cervical Cancer Treated by Laparoscopic Radical Vaginal Hysterectomy

  • Jin Hwa Hong
  • Joong Sub Choi
  • Jung Hun Lee
  • Chang Eop Son
  • Seung Wook Jeon
  • Jong Woon Bae
  • Jeong Min Eom
Gynecologic Oncology



The goal of this study was to evaluate the operative feasibility and survival for patients with stage IB2 cervical cancer who undergo laparoscopic radical vaginal hysterectomy (LRVH) compared with those with stage IB1 cervical cancer.


We identified 90 patients who were eligible to participate in the study through retrospective analysis of medical records from March 2003 to June 2010. Patients with stage IB1 cervical cancer were divided into two groups by a cutoff value of 2 cm for tumor size. Data regarding surgicopathologic risk factors, surgical outcomes, and survival rates were compared among three groups (two with stage IB1 and one with stage IB2).


The tumor size was ≤2 cm in 27 patients, 2–4 cm in 30, and >4 cm in 33. The number of intermediate and high-risk factors was significantly lower in patients with stage IB1 cervical cancer (≤2 cm) than in those with stage IB2. Surgical outcomes (mean operating time, estimated blood loss, number of harvested lymph nodes, and sites of metastatic lymph nodes) did not show any significant difference among the three groups. The rates of intraoperative complications also did not differ among the three groups (P = 0.833). The estimated 5-year recurrence-free and overall survival rates were not significantly different among the three groups (P = 0.253 and 0.525, respectively).


LRVH for stage IB2 cervical cancer can be performed with similar safety and survival rates compared to stage IB1 cervical cancer. Overall, LRVH is feasible for the treatment of stage IB2 cervical cancer.


Overall Survival Cervical Cancer Harvest Lymph Node Stromal Invasion Cardinal Ligament 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We declare that there is no commercial interest or any financial support. We have no conflict of interest in this article.


  1. 1.
    Creasman WT. New gynecologic cancer staging. Gynecol Oncol. 1995;58(2):157–8.PubMedCrossRefGoogle Scholar
  2. 2.
    Kim HS, Song YS. International Federation in Gynecology and Obstetrics (FIGO) staging system revised. What should be considered critically for gynecologic cancer? J Gynecol Oncol. 2009;20(3):135–6.PubMedCrossRefGoogle Scholar
  3. 3.
    Rutledge TL, Kamelle SA, Tillmanns TD, Gould NS, Wright JD, Cohn DE, et al. A comparison of stage IB1 and IB2 cervical cancers treated with radical hysterectomy. Is size the real difference? Gynecol Oncol. 2004;95:70–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Horn LC, Fischer U, Raptis G, Bilek K, Hentschel B. Tumor size is of prognostic value in surgically treated FIGO stage II cervical cancer. Gynecol Oncol. 2007;107:310–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Finan MA, DeCesare S, Fiorica JV, Chambers R, Hoffman MS, Kline RC, et al. Radical hysterectomy for stage IB1 vs IB2 carcinoma of the cervix: does the new staging system predict morbidity and survival? Gynecol Oncol. 1996;62:139–47.PubMedCrossRefGoogle Scholar
  6. 6.
    Wagenaar HC, Trimbos JB, Postema S, Anastasopoulou A, van der Geest RJ, Reiber JH, et al. Tumor diameter and volume assessed by magnetic resonance imaging in the prediction of outcome for invasive cervical cancer. Gynecol Oncol. 2001;82:474–82.PubMedCrossRefGoogle Scholar
  7. 7.
    Turan T, Yildirim BA, Tulunay G, Boran N, Kose MF. Prognostic effect of different cut-off values (20 mm, 30 mm, and 40 mm) for clinical tumor size in FIGO stage IB cervical cancer. Surg Oncol. 2010;19:106–13.PubMedCrossRefGoogle Scholar
  8. 8.
    Naik R, Jackson KS, Lopes A, Cross P, Henry JA. Laparoscopic assisted radical vaginal hysterectomy versus radical abdominal hysterectomy—a randomized phase II trial: perioperative outcomes and surgicopathological measurements. BJOG. 2010;117:746–51.PubMedCrossRefGoogle Scholar
  9. 9.
    Nam JH, Kim JH, Kim DY, Kim MK, Yoo HJ, Kim YM, et al. Comparative study of laparoscopico-vaginal radical hysterectomy and abdominal radical hysterectomy in patients with early cervical cancer. Gynecol Oncol. 2004;92:277–83.PubMedCrossRefGoogle Scholar
  10. 10.
    Steed H, Rosen B, Murphy J, Laframboise S, De Petrillo D, Covens A. A comparison of laparoscopic-assisted radical vaginal hysterectomy and radical abdominal hysterectomy in the treatment of cervical cancer. Gynecol Oncol. 2004;93:588–93.PubMedCrossRefGoogle Scholar
  11. 11.
    Lee CL, Wu KY, Huang KG, Lee PS, Yen CF. Long-term survival outcomes of laparoscopically assisted radical hysterectomy in treating early-stage cervical cancer. Am J Obstet Gynecol. 2010;203:165.e1–7.Google Scholar
  12. 12.
    Spirtos NM, Eisenkop SM, Schlaerth JB, Ballon SC. Laparoscopic radical hysterectomy (type III) with aortic and pelvic lymphadenectomy in patients with stage I cervical cancer: surgical morbidity and intermediate follow-up. Am J Obstet Gynecol. 2002;187:340–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Mehra G, Weekes A, VanTrappen P, Visvanathan D, Jeyarajah A. Laparoscopic assisted radical vaginal hysterectomy for cervical carcinoma: morbidity and long-term follow-up. Eur J Surg Oncol. 2010;36:304–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Querleu D, Morrow CP. Classification of radical hysterectomy. Lancet Oncol. 2008;9:297–303.PubMedCrossRefGoogle Scholar
  15. 15.
    Hoh JK, Choi JS, Lee JH, Lee KW, Han JS, Lee EJ. Repeat laparoscopic para-aortic lymphadenectomy for an isolated lymph node recurrence in a patient with stage IB2 cervical cancer. J Minim Invasive Gynecol. 2009;16:781–4.PubMedCrossRefGoogle Scholar
  16. 16.
    Sevin BU, Nadji M, Lampe B, Lu Y, Hilsenbeck S, Koechli OR, et al. Prognostic factors of early stage cervical cancer treated by radical hysterectomy. Cancer. 1995;76:1978–86.PubMedCrossRefGoogle Scholar
  17. 17.
    Petsuksiri J, Chansilpa Y, Therasakvichya S, Suntornpong N, Thephamongkhol K, Dankulchai P, et al. Treatment options in bulky stage IB cervical carcinoma. Int J Gynecol Cancer. 2008;18:1153–62.PubMedCrossRefGoogle Scholar
  18. 18.
    Eifel PJ. Chemoradiation for carcinoma of the cervix: advances and opportunities. Radiat Res. 2000;154:229–36.PubMedCrossRefGoogle Scholar
  19. 19.
    Morris M, Eifel PJ, Lu J, Grigsby PW, Levenback C, Stevens RE, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med. 1999;340:1137–43.PubMedCrossRefGoogle Scholar
  20. 20.
    Keys HM, Bundy BN, Stehman FB, Muderspach Ll, Chafe WE, Suggs CL 3rd, et al. Cisplatin, radiation, and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med. 1999;340:1154–61.PubMedCrossRefGoogle Scholar
  21. 21.
    Eddy GL, Bundy BN, Creasman WT, Spirtos NM, Mannel RS, Hannigan E, et al. Treatment of (“bulky”) stage IB cervical cancer with or without neoadjuvant vincristine and cisplatin prior to radical hysterectomy and pelvic/para-aortic lymphadenectomy: a phase III trial of the gynecologic oncology group. Gynecol Oncol. 2007;106:362–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Napolitano U, Imperato F, Mossa B, Framarino ML, Marziani R, Marzetti L. The role of neoadjuvant chemotherapy for squamous cell cervical cancer (Ib-IIIb): a long-term randomized trial. Eur J Gynaecol Oncol. 2003;24:51–9.PubMedGoogle Scholar
  23. 23.
    Sardi JE, Giaroli A, Sananes C, Ferreira M, Soderini A, Bermudez A, et al. Long-term follow-up of the first randomized trial using neoadjuvant chemotherapy in stage Ib squamous carcinoma of the cervix: the final results. Gynecol Oncol. 1997;67:61–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Cai HB, Chen HZ, Yin HH. Randomized study of preoperative chemotherapy versus primary surgery for stage IB cervical cancer. J Obstet Gynaecol Res. 2006;32:315–23.PubMedCrossRefGoogle Scholar
  25. 25.
    Sobiczewski P, Bidzinski M, Derlatka P, Panek G, Danska-Bidzinska A, Gmyrek L, et al. Early cervical cancer managed by laparoscopy and conventional surgery: comparison of treatment results. Int J Gynecol Cancer. 2009;19:1390–5.PubMedCrossRefGoogle Scholar
  26. 26.
    Kristensen GB, Abeler VM, Risberg B, Trop C, Bryne M. Tumor size, depth of invasion, and grading of the invasive tumor front are the main prognostic factors in early squamous cell cervical carcinoma. Gynecol Oncol. 1999;74:245–51.PubMedCrossRefGoogle Scholar
  27. 27.
    Lee JM, Lee KB, Park CY. Prognostic factors predicting survival in patients with FIGO stage IB cervical cancer treated surgically. Int J Gynaecol Obstet. 2006;94:143–4.PubMedCrossRefGoogle Scholar
  28. 28.
    Comerci G, Bolger BS, Flannelly G, Maini M, de Barros Lopes A, Monaghan JM. Prognostic factors in surgically treated stage IB-IIB carcinoma of the cervix with negative lymph nodes. Int J Gynecol Cancer. 1998;8:23–6.PubMedCrossRefGoogle Scholar
  29. 29.
    Ryu HS, Kang SB, Kim KT, Chang KH, Kim JW, Kim JH. Efficacy of different types of treatment in FIGO stage IB2 cervical cancer in Korea: results of a multicenter retrospective Korean study (KGOG-1005). Int J Gynecol Cancer. 2007;17:132–6.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Jin Hwa Hong
    • 1
  • Joong Sub Choi
    • 1
  • Jung Hun Lee
    • 1
  • Chang Eop Son
    • 1
  • Seung Wook Jeon
    • 1
  • Jong Woon Bae
    • 1
  • Jeong Min Eom
    • 1
  1. 1.Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea

Personalised recommendations