Radical hysterectomy is recommended for women with early stage cervical cancer, although the need for extensive surgery in those with FIGO stage IA₂–IB₁ disease that meets criteria for low risk (limited stromal invasion and no pelvic node involvement) is questionable based on retrospective evidence indicating that parametrial invasion is very rare in these patients. Now, the results of the phase III SHAPE trial demonstrate that simple hysterectomy is safer than radical surgery and confers non-inferior oncological outcomes in this setting.

A total of 700 patients with stage IA₂–IB₁ low-risk cervical cancer were randomly allocated (1:1) to undergo simple or radical hysterectomy. Cancer recurrence in the pelvic area 3 years after randomization was the primary end point. Open versus minimally invasive surgery was performed at the surgeon’s discretion; 17% and 29% of patients in the simple and radical hysterectomy groups, respectively, had open abdominal surgery.

建议对患有早期宫颈癌的女性进行根治性子宫切除术，尽管基于回顾性分析，对于符合低风险标准（有限间质侵犯且无盆腔淋巴结受累）的FIGO IA ₂ –IB ₁期疾病的患者是否需要进行广泛手术是值得怀疑的有证据表明宫旁侵犯在这些患者中非常罕见。现在，III 期 SHAPE 试验的结果表明，简单的子宫切除术比根治性手术更安全，并且在这种情况下具有不劣质的肿瘤学结果。

共有 700 名 IA ₂ –IB ₁期低危宫颈癌患者被随机分配（1:1）接受简单或根治性子宫切除术。随机分组后 3 年骨盆区域的癌症复发是主要终点。开放手术还是微创手术由外科医生决定进行；单纯子宫切除术组和根治性子宫切除术组中分别有 17% 和 29% 的患者接受了开腹手术。