Comparison between Q-M type B and C2 abdominal radical hysterectomy for FIGO 2018 stage IB1 cervical cancer:a multicentre retrospective study

Abstract Objective: To compare the oncological results and surgical outcomes of abdominal Q-M type B and type C2 radical hysterectomy (RH) for patients with FIGO 2018 stage IB1 cervical cancer.Methods: We retrospectively compared the oncological results and surgical outcomes of 1158 cervical cancer patients treated with Q-M type B (n=775) or type C2 (n=383) RH between January 2004 and December 2018 at 47 hospitals in mainland China.Results: The type B group and type C2 group showed similar 5-year DFS and OS rates (OS: 98.5% vs 98.0%, P=0.461; DFS: 94.3% vs 93.3%, p=0.461) in the total study population. Multivariable analysis revealed that Q-M type B RH was not associated with a worse 5-year OS rate (hazard ratio [HR]=1.493; 95% CI=0.522-4.269, P=0.455 95% CI: 0.522-4.269;p=0.455) or DFS rate (HR=1.169;95%CI: 0.650-2.101;p=0.603). Compared with type C2, type C resulted in a significantly shorter operating time (215 min vs. 188 min, P＜0.001). The defecation time and atherization time were less in the type B group than in the type C2 RH group (3.04 d vs. 2.81 d, P<0.001; 10.59 d vs. 8.97 d, P<0.001). Additionally, intraoperative complications occurred with Q-M type C2 RH compared with Q-M type B RH (OR = 11.287, 95% CI= 4.667-27.300, P＜0.001). Conclusion: Among cervical cancer patients with FIGO 2018 stage IB1 disease, the oncological outcomes of Q-M type B RH and Q-M type C2 RH were similar, and Q-M type B RH was associated with a shorter operation time, less intraoperative blood loss and fewer intraoperative complications. This suggests that Q-M type B RH might be an rational option for FIGO 2018 stage IB1 cervical cancer.