Nerve-sparing radical hysterectomy for cervical cancer causes less bladder and colorectal dysfunction than standard techniques, but doesn’t adversely affect survival, These are the reassuring findings from two studies carried out in Italy and the Czech Republic, and reported at the 16th International Meeting of the European Society of Gynaecological Oncology (ESGO) in Belgrade, Serbia, 11-14 October 2009.

In a study of 200 patients reported by Dr Francesco Raspagliesi, from the National Cancer Institute in Milan, Italy, two and five year disease free survival after nerve-sparing surgery was 89% and 81% respectively – comparable with survival rates commonly reported in studies of radical hysterectomy in which nerve-sparing techniques are not used. But the complication rate of 3.5% was lower than seen with conventional techniques.

The second study, carried out by Dr David Cibula and colleagues at the General Faculty Hospital of Charles University, Prague, Czech Republic, directly compared morbidity six months after nerve sparing surgery with that seen with two standard radical hysterectomy techniques in 87 women with cervical cancer. Those who had surgery which left key pelvic nerves intact had significantly less urinary incontinence, defecation irregularity, bladder emptying problems and nocturia than those had more invasive surgery (p<0.05 all parameters).

Dr Cibula concluded that it was nerve-sparing techniques which made the difference to the complications that women experienced after surgery, rather than the extent of the hysterectomy itself, and Dr Raspagliesi recommended that nerve-sparing techniques should now be considered for all cervical cancer surgery.