When Less Is More — The Importance of Patient Selection

This editorial discusses the evolving surgical standards in gynecologic oncology, particularly the shift from radical hysterectomy to more conservative approaches for early stage cervical cancer. It highlights findings from the SHAPE trial, which demonstrated noninferiority of simple hysterectomy compared to radical hysterectomy in low risk patients, with fewer complications and better quality of life outcomes. The author emphasizes the importance of precise patient selection, noting that tumor size, depth of invasion, and lymphovascular involvement must be carefully assessed. While the results support conservative surgery in select cases, radical hysterectomy remains necessary for patients who fall outside these criteria.

This editorial discusses the evolving surgical standards in gynecologic oncology, particularly the shift from radical hysterectomy to more conservative approaches for early stage cervical cancer. It highlights findings from the SHAPE trial, which demonstrated noninferiority of simple hysterectomy compared to radical hysterectomy in low risk patients, with fewer complications and better quality of life outcomes. The author emphasizes the importance of precise patient selection, noting that tumor size, depth of invasion, and lymphovascular involvement must be carefully assessed. While the results support conservative surgery in select cases, radical hysterectomy remains necessary for patients who fall outside these criteria.