[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-336266-105":59,"doc-detail-336266-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","local-excision-as-a-viable-alternative-to-hysterectomy-for-early-stage-cervical-cancer-commentary","Local excision as a viable alternative to hysterectomy for early-stage cervical cancer - Commentary","","A scholarly commentary evaluates local excision (fertility-sparing surgery, FSS) as an alternative to hysterectomy for early-stage cervical cancer in women of reproductive age. Using SEER retrospective cohort data covering 18,519 reproductive-age patients, the discussion summarizes survival findings: similar overall and disease-specific survival for local excision versus hysterectomy under age 39, with worse outcomes for patients over 40 and more nuanced stage IA versus stage IB results. The commentary highlights strengths such as sample size and reliability for guiding care, while addressing key limitations including nonprospective design, selection bias, limited generalizability beyond American patients, and confounding related to fertility intentions and access to reproductive care.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/local-excision-as-a-viable-alternative-to-hysterectomy-for-early-stage-cervical-cancer-commentary/336266/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/local-excision-as-a-viable-alternative-to-hysterectomy-for-early-stage-cervical-cancer-commentary/336266.png","ImageObject",300,407,{"name":92,"@type":93},"Aurora","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What does the commentary conclude about local excision compared with hysterectomy for early-stage cervical cancer?","Question",{"text":113,"@type":114},"Local excision is presented as a feasible fertility-sparing option with survival outcomes comparable to hysterectomy for selected groups, particularly those under 39 and patients with stage IA disease, while outcomes are less favorable for older patients and stage IB in the summarized results.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What data source and study design are used to support the discussion?",{"text":118,"@type":114},"The commentary summarizes findings from a retrospective cohort analysis using the Surveillance, Epidemiology, and End Results (SEER) Program data.",{"name":120,"@type":111,"acceptedAnswer":121},"What limitations are emphasized in the commentary?",{"text":122,"@type":114},"Key limitations include a nonprospective design with well-known associated biases, restriction to American patients affecting generalizability, and confounding variables related to fertility intent and access to reproductive care.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},336266,1790168013,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":24},4810365810221,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","’Correspondence  \nA commentary on ‘Local excision as a viable alternative to hysterectomy for early-stage cervical cancer in women of reproductive age: a populationbased cohort study’  \nJianxia Zhang, BSc, Huiling Qiu, BSc, Yinxia Qing, BSc, Yanxia Hu, BSc, Huaxiang Deng, BSc*  \nCervical cancer is one of the primary causes of cancer-related fatalities in women. It ranks fourth in the world among women’s malignant tumor incidence, with 85% of cases occurring in developing nations[1] . Chen et al. [2] conducted a retrospective population analysis on female patients diagnosed with primary cervical cancer for the first time. It appears that hysterectomy is still the best course of treatment for patients who do not require reproductive assistance, and fertility-sparing surgery (FSS) through local excision is a feasible option that can help patients under 40 with stage IA cervical cancer achieve a well-balanced outcome between tumor control and fertility preservation.  \nData from the Surveillance, Epidemiology, and End Results (SEER) Program were used in this retrospective cohort analysis, which comprised 18 519 patients with cervical cancer who were of reproductive age and 2268 fatalities that were noted. Seventyone percent of patients had a hysterectomy and 17.0% had FSS by local excision. The results of the study showed that while overall survival (OS) and disease-specific survival (DSS) of local excision were similar to those of hysterectomy in patients under 39, they were much worse in patients over 40 than they were with hysterectomy. Furthermore, in patients with stage IA cervical cancer, the OS and DSS of local excision were comparable to hysterectomy; however, in patients with stage IB cervical cancer, the OS and DSS of local excision were less favorable than hysterectomy.  \nThis essay has several benefits and sources of inspiration. The trial’s high sample size and retrospective population study design made it possible to detect any clinically meaningful group differences, which was one of its benefits. As a result, the study provides trustworthy findings to direct care. Still, there were a lot  \nDepartment of Gynaecology, Boao Yiling Care Center, Qionghai, 571400 Hainan, People’s Republic of China  \nJianxia Zhang and Huiling Qiu contributed equally to the article.  \nSponsorships or competing interests that maybe relevant to content are disclosed atthe end of this article.  \n*Corresponding author. Address: Department of gynaecology, Boao Yiling Care Center, Qionghai Hainan 571400, People’s Republic of China. Tel.: +795 135 451 34743.  \nE-mail: [1049552781@qq.com](1049552781@qq.com) (H. Deng).  \nCopyright © 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.  \nInternational Journal of Surgery (2024) 110:3120–3121  \nReceived 31 January 2024; Accepted 4 February 2024  \nPublished online 21 February 2024  \n[http://dx.doi.org/10.1097/JS9.0000000000001218](http://dx.doi.org/10.1097/JS9.0000000000001218)  \nof limitations. First, only American patients were included in this study. Patients’ management approaches may differ significantly from those in other nations. When extrapolating the findings to patients worldwide, these distinctions must be taken into consideration. Second, the research design’s primary flaw – along with all the well-known associated biases – is that it is nonprospective[3] . Finally, there are still a lot of confounding variables among women who have fertility-sparing surgery because it is unclear how many of these women were actively trying to conceive or had access to reproductive care. This is oneof the study’s main drawbacks[4] .  \nThis study explores if FSS via local excision could result in a comparable or even be","cbCaiayLzmmpr7Oi","https://ap.wps.com/l/cbCaiayLzmmpr7Oi","pdf",197330,"English","# Background and rationale\n## Hysterectomy vs fertility-sparing surgery\n# Study design and data source\n## SEER retrospective cohort\n# Key survival findings\n## Age-based comparisons\n## Stage IA and stage IB comparisons\n# Benefits of the commentary\n## Sample size and clinical group differences\n# Limitations and confounding factors\n## Nonprospective bias and generalizability\n# Future evidence and clinical implications\n## Need for multicenter prospective research","[{\"question\":\"What does the commentary conclude about local excision compared with hysterectomy for early-stage cervical cancer?\",\"answer\":\"Local excision is presented as a feasible fertility-sparing option with survival outcomes comparable to hysterectomy for selected groups, particularly those under 39 and patients with stage IA disease, while outcomes are less favorable for older patients and stage IB in the summarized results.\"},{\"question\":\"What data source and study design are used to support the discussion?\",\"answer\":\"The commentary summarizes findings from a retrospective cohort analysis using the Surveillance, Epidemiology, and End Results (SEER) Program data.\"},{\"question\":\"What limitations are emphasized in the commentary?\",\"answer\":\"Key limitations include a nonprospective design with well-known associated biases, restriction to American patients affecting generalizability, and confounding variables related to fertility intent and access to reproductive care.\"}]","Local excision as a viable alternative to hysterectomy for early-stage cervical cancer - Commentary | PDF",1790014295]