Is less more? Rethinking the extent of surgery for invasive cervical cancer

The surgical treatment of early-stage cancer of the cervix is undergoing renewed scrutiny in an effort to minimize complications, preserve fertility when desired by the patient, and yet avoid any compromise of therapeutic efficacy. With regard to radical hysterectomy, the extent of the parametrial resection and lymphadenectomy are two topics of particular interest. A review of the relevant literature concerning radical hysterectomy and cervical cancer that supports a less radical approach is discussed. For women with stage I cervical cancer, a less radical resection appears to offer more when considered in the context of fewer immediate and long-term complications and comparable long-term survival.