Real-World Guideline Concordance and Potential Overtreatment Following Primary Radical Hysterectomy for Early-Stage Cervical Cancer

Background/Objectives: International guidelines recommend risk-adapted postoperative management in early-stage cervical cancer; however, the extent to which these recommendations are implemented in routine clinical practice remains incompletely characterized, particularly among patients without high-risk pathological features. This study evaluated real-world concordance with the 2023 European Society of Gynecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology (ESGO/ESTRO/ESP) recommendations and investigated the clinical implications of potential overtreatment.

Methods

We retrospectively evaluated a single-center cohort of 135 patients treated with primary radical hysterectomy for early-stage cervical cancer at our institution. Postoperative pathological risk factors were used to stratify patients in accordance with the 2023 ESGO/ESTRO/ESP guidelines. Postoperative management was classified as guideline-concordant or potential overtreatment. Disease-free survival (DFS) and overall survival (OS) were assessed by Kaplan–Meier analysis and univariable Cox proportional hazards regression.