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Radical Hysterectomy for Non-Endometrioid Endometrial Cancer With Cervical Involvement: A Retrospective Cohort Study
Yu Xu1,2, Yi Du1,2, Zhaojuan Qin1,2
1Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Journal of Surgical Oncology
|July 16, 2026
Summary
Radical hysterectomy offers no survival advantage over simple hysterectomy for non-endometrioid endometrial cancer with cervical involvement. This study found no significant difference in overall or disease-free survival between the two surgical approaches.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Clinical Research
Background:
- Endometrial cancer with cervical involvement presents unique treatment challenges.
- The optimal surgical approach, radical versus simple hysterectomy, remains debated for these cases.
Purpose of the Study:
- To compare the survival outcomes of radical hysterectomy versus simple hysterectomy in patients with non-endometrioid endometrial cancer involving the cervix.
- To determine if radical hysterectomy provides a survival benefit in this specific patient population.
Main Methods:
- A multicenter retrospective cohort study involving 422 women with uterine serous carcinoma or uterine clear cell cancer.
- Patients were categorized based on undergoing either radical or simple hysterectomy.
- Survival outcomes (overall survival and disease-free survival) were analyzed using Kaplan-Meier, log-rank tests, and Cox regression models.
Main Results:
- The study included 275 women who had radical hysterectomy and 147 who had simple hysterectomy, with no significant baseline differences.
- Recurrence rates were similar between the groups (23.8% vs. 20.4%).
- Radical hysterectomy was not associated with improved overall survival (HR 0.93) or disease-free survival (HR 0.96) compared to simple hysterectomy. Adjusted analyses confirmed no impact of hysterectomy type on survival.
Conclusions:
- Radical hysterectomy does not confer a survival benefit for non-endometrioid endometrial cancer with cervical involvement.
- The choice between radical and simple hysterectomy may not significantly impact patient survival in this context.
- Further research may explore other factors influencing outcomes in these complex cases.
