Cancer Research Lab

Supracervical hysterectomy may be a reasonable alternative to total abdominal hysterectomy for women with advanced epithelial ovarian cancer, according to a report in the March Obstetrics & Gynecology.

Although oncologists have traditionally recommended total abdominal hysterectomy for women with ovarian cancer, the authors explain, many oncologists now recommend supracervical hysterectomy for those who will receive intraperitoneal chemotherapy because it may limit vaginal leakage of the chemotherapeutic agents.

Dr. Pedro T. Ramirez from University of Texas M. D. Anderson Cancer Center, Houston, and associates compared clinical outcomes in 47 women who underwent supracervical hysterectomy and 190 women who underwent total abdominal hysterectomy for advanced ovarian cancer.

Although intraoperative complications did not differ between the two groups, the authors report, a greater proportion of women who underwent total abdominal hysterectomy had optimal tumor cytoreduction (64.7% versus 30% for supracervical hysterectomy).

The two groups did not differ significantly in progression or rates of recurrence, vaginal bleeding, vaginal discharge or and dysuria during follow-up.

Overall survival and progression-free survival also did not differ in the two groups, the researchers note.

There were no difficulties in physical examinations due to the presence of the cervical stump in the supracervical hysterectomy group and fewer cases of tumor erosion into the vagina compared with the total abdominal hysterectomy group.

“At present, supracervical hysterectomy is not routinely performed or recommended at M. D. Anderson Hospital,” the investigators note. “However, supracervical hysterectomy may merit further consideration given the findings of our present study and the recent findings of improved survival in patients treated with intraperitoneal chemotherapy for ovarian cancer.”

“The option of supracervical hysterectomy should be reviewed with patients preoperatively during a discussion of potential indications for and benefits of different surgical techniques,” the researchers conclude.