Correspondence - A commentary on 'Effect of preoperative radiotherapy on stage IB2 and IIA2 cervical cancer: A retrospective cohort study' - discussion

Sep 21, 2026

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A correspondence-style commentary reviews findings from a retrospective study of preoperative intracavitary radiotherapy combined with radical surgery for stage IB2 and IIA2 cervical cancer. It summarizes reported benefits in locoregional control without increasing surgical complications, and contrasts existing treatment strategies for stage IB2/IIA2 disease, including chemoradiotherapy, radical surgery, and combinations with or without neoadjuvant or adjuvant therapy. The commentary also discusses limitations such as selection bias and missing clinical feature reporting, and calls for prospective multicenter randomized trials and longer follow-up.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Correspondence

Overview of the referenced retrospective study

Background: cervical cancer burden and treatment options for stage IB2/IIA2

Summary of evidence and comparative effectiveness

Limitations and data-reporting considerations

Clinical uncertainty and need for further research

’Correspondence A commentary on ‘Effect of preoperative radiotherapy on stage IB2 and IIA2 cervical cancer: A retrospective cohort study’ Siyu Wu, MD, Xiaoyu Yue, MSc, Yaping Wang, MSc* It was with great interest that we read the article published in the International Journal of Surgery. Zhang et al. [1] conducted a retrospective study on preoperative intracavitary radiotherapy combined with radical surgery in patients with stage IB2 and IIA2 cervical cancer (CC) . The ﬁndings showed that radical surgery plus preoperative irradiation could raise the rate of locoregional control without raising the risk of surgical complications. CC is a common malignant tumor of the female genital tract that gravely endangers women’s health. Approximately 560 000 new instances of CC are identiﬁed worldwide each year, with developing nations accounting for 80% of these cases. Early cervical malignancies have traditionally been treated with surgery, whereas advanced cases have been treated with chemotherapy and radiation. Regarding the best course of action for cervical tumors at stage IB2, which lies between early and advanced illness, there remains, still, disagreement. Chemoradiotherapy (CCRT), radical surgery (RS), radical surgery after chemoradiotherapy (CCRT+RS), neoadjuvant chemotherapy followed by radical surgery (NACT+RS), adjuvant radiotherapy followed by radical surgery (RT+RS), and radiotherapy alone (RT) are the mainstays of treatment for stage IB2/IIA2 CC. According to the ﬁndings of a recent study, individuals with 2009 FIGO (International Federation of Gynecology and Obstetrics) stage IB2/IIA2 CC had comparable therapy options, including primary surgical treatment (PST), NACT+RS, and CCRT[2]. The results of Zhou et al. [3] demonstrated that RS combined with adjuvant therapy is a workable and successful treatment for IB2/ IIA2 CC, with a respectable incidence of comorbidities and a good 5-year survival rate. A Bayesian network meta-analysis revealed that CCRT would be the most effective strategy for enhancing the clinical outcome of patients with CC diagnosed at FIGO (2009) stage IB2/IIA2[4]. Department of Gynecology and Obstetrics, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 266000 Qingdao, People’s Republic of China Sponsorships or competing interests that maybe relevant to content are disclosed atthe end of this article. *Corresponding author. Address: Department of Gynecology and Obstetrics, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, 266000 Qingdao, People ’s Republic of China. Tel.: +86 185 618 105 16. [E-mail: wyp020520@qlyyqd.com](E-mail: wyp020520@qlyyqd.com) (Y. Wang). Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution-ShareAlike License 4.0, which allows others to remix, tweak, and build upon the work, even for commercial purposes, as long as the author is credited and the new creations are licensed under the identical terms. International Journal of Surgery (2024) 110:3998–3999 Received 23 February 2024; Accepted 25 February 2024 Published online 18 March 2024 [http://dx.doi.org/10.1097/JS9.0000000000001314](http://dx.doi.org/10.1097/JS9.0000000000001314) This research looks at the potential beneﬁts of both urgent radical surgery and preoperative radiation. This creative approach provides enlightening guidance and inspiration for the continued development of this area of research. Still, there were alot of limitations. First, there may be some selection bias in this single-center retrospective investigation. Secondly, bias resulted from the absence of some clinical features, such as a past illness. In addition to the demographic information and clinical factors gathered, information on pretreatment hemoglobin, lymph node metastases, vascular tumor thrombus, vaginal margin, deep stromal penetration, and any adjuvant treatment o

FAQs

What key outcome does the commentary highlight from the retrospective study?

It highlights that radical surgery combined with preoperative irradiation can improve locoregional control without increasing the risk of surgical complications.

Which treatment approaches are discussed as mainstays for stage IB2/IIA2 cervical cancer?

The commentary lists chemoradiotherapy, radical surgery, radical surgery after chemoradiotherapy, neoadjuvant chemotherapy followed by radical surgery, adjuvant radiotherapy followed by radical surgery, and radiotherapy alone.

Why does the commentary emphasize the need for additional studies?

It notes limitations such as selection bias in a single-center retrospective design and challenges monitoring long-term outcomes, and it calls for prospective multicenter randomized trials with larger samples and longer follow-up.

Sep 21, 2026

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