Cuts just right.

The Japanese are at it again with popularizing extended surgical techniques as heroic one-stop shops for advanced cancer. The current NCCN-preferred treatment for stage IB2/IIA2/IIB cervical cancer is definitive chemoradiation to avoid trimodality toxicity. Here’s a retrospective look at 120 consecutive women treated with “Okabayashi-Kobayashi” radical hysterectomy with bilateral nerve preservation for stage IB1/IB2 disease and unilateral nerve preservation for stage IIA/IIB if extra-uterocervical disease was confined to one side. The kicker here is that only half received adjuvant chemo and a mere 5 patients (4%) adjuvant radiation yet the 5-year local control and overall survival, respectively, were 99% and 95% for stage IB disease and 87% and 82% for stage II. TBL: Selective nerve-sparing radical hysterectomy may afford excellent cancer outcomes while still avoiding trimodality therapy for stage IB2/IIA2/IIB cervical cancer. | Sakurgi, JAMA Netw Open 2020