Do the results of the ConCerv and SHAPE trials alter how you might counsel a patient incidentally found to have ≤IB1 after simple hysterectomy?
Would you still discuss the option of parametrectomy/upper vaginectomy if they would have met the criteria for SHAPE?
Answer from: at Academic Institution
The ConCerv and SHAPE trials have demonstrated that selected patients with low-risk, less than or equal to stage IB1 cervical cancers can be safely treated with simple, extrafascial hysterectomy with lymph node assessment. Given those findings, if a patient met the criteria for inclusion in the ConC...
No, for IB1 or less following hysterectomy I would not offer a parametrectomy or upper vaginectomy. If the stage was IB1 or IA2 I would make sure the patient's nodes had been evaluated pathologically.
No, I would not discuss a parametrectomy or upper vaginectomy for these patients if the stage is <= IB1, however, I would consider taking them back for evaluation of the lymph nodes if they were not evaluated, or serial imaging with PET scans.