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Original Research

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Comparison of survival outcomes following radiotherapy versus radical hysterectomy in patients with stage IIA cervical squamous cell carcinoma

  • Mingwei Li1,2,†
  • Ping Liu1,†
  • Danbo Wang3,†
  • Hui Duan1,†
  • Xuemei Zhan2
  • Yi Zhang4
  • Qinghuang Xie5
  • Biliang Chen6
  • Zhumei Cui7
  • Qiubo Lv8
  • Hailin Wang9
  • Xiaonong Bin10
  • Jinghe Lang11,*,
  • Chunlin Chen1,*,

1Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 510000 Guangzhou, Guangdong, China

2Department of Gynecology, Jiangmen Central Hospital, 529030 Jiangmen, Guangdong, China

3Department of Gynecology, Liaoning Cancer Hospital, 110801 Shenyang, Liaoning, China

4Department of Gynecology, The First Hospital of China Medical University, 110001 Shenyang, Liaoning, China

5Department of Obstetrics and Gynecology, Foshan Women and Children Hospital, 528099 Foshan, Guangdong, China

6Department of Obstetrics and Gynecology, Xijing Hospital of Airforce Medical University, 710032 Xi’an, Shaanxi, China

7Department of Gynecology, The Affiliated Hospital of Qingdao University, 266003 Qingdao, Shandong, China

8Department of Obstetrics and Gynecology, Beijing Hospital, 100730 Beijing, China

9Department of Obstetrics and Gynecology, Gansu Provincial Hospital, 730020 Lanzhou, Gansu, China

10Department of Epidemiology, College of Public Health, Guangzhou Medical University, 511495 Guangzhou, Guangdong, China

11Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, 100005 Beijing, China

DOI: 10.22514/ejgo.2023.021 Vol.44,Issue 2,April 2023 pp.42-49

Submitted: 16 June 2022 Accepted: 22 September 2022

Published: 15 April 2023

*Corresponding Author(s): Jinghe Lang E-mail:
*Corresponding Author(s): Chunlin Chen E-mail:

† These authors contributed equally.


This study explored the differences in survival outcomes of cervical squamous cell carcinoma (SCC) patients diagnosed with stage IIA who underwent radical hysterectomy (RH) versus radiotherapy (RT). Eligible stage IIA cervical SCC cases were screened from the C4 database. They were divided into RH and RT groups based on their treatments and in a 1:2 ratio utilizing propensity score matching (PSM). Their 5-year overall survival (OS) and disease-free survival (DFS) before and after PSM were compared. Before PSM analysis, the results showed that patients from the RT group (n = 421) had significantly poorer 5-year OS and DFS rates compared with the RH group (n = 761) (OS: 77.2%vs. 85.6%, p < 0.001, HR = 1.789; DFS: 74.9% vs. 80.0%, p = 0.006, HR = 1.447). After stratification in a 1:2 ratio, PSM analysis results showed that the 5-year OS and DFS rates of stage IIA1 patients from the RT group (n = 226) were significantly poorer than the RH group (n = 429) (OS: 78.1% vs. 87.2%, p < 0.001, HR = 2.203; DFS: 78.2% vs. 83.7%, p = 0.011, HR = 1.681), while no significant difference in 5-year OS and DFS rates were observed between the RT (n = 173) and RH (n = 266) groups (OS: 75.2% vs. 83.8%, p = 0.054; DFS: 71.4% vs. 79.5%, p = 0.070) of stage IIA2 patients. RH was associated with better OS and DFS outcomes than RT in cervical SCC patients diagnosed with stage IIA disease. Subgroup analyses showed that RH had superior OS and DFS benefits than RT in stage IIA1 cases, while no significant difference in survival was observed for stage IIA2 patients.


Cervical cancer; Radical hysterectomy; Radiotherapy; Overall survival; Disease-free survival

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Mingwei Li,Ping Liu,Danbo Wang,Hui Duan,Xuemei Zhan,Yi Zhang,Qinghuang Xie,Biliang Chen,Zhumei Cui,Qiubo Lv,Hailin Wang,Xiaonong Bin,Jinghe Lang,Chunlin Chen. Comparison of survival outcomes following radiotherapy versus radical hysterectomy in patients with stage IIA cervical squamous cell carcinoma. European Journal of Gynaecological Oncology. 2023. 44(2);42-49.


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