Radical surgery for early stage cervical cancer

Cervical cancer is one of the most common malignancies in women worldwide. Due to an effective screening programme, in the Netherlands cervical cancer is often detected in early stages of disease. For early stage (International Federation of Gynaecology and Obstetrics (FIGO) stage IB/IIA) cervical cancer, radical surgery followed by adjuvant radiotherapy in the finding of poor prognostic factors and primary (chemo-)radiotherapy are equally effective treatment options. Survival rates after treatment are relatively good with 5 year survival rates of 85-95%. Unfortunately, treatment for cervical cancer may induce morbidity. Both surgery and radiotherapy are known to affect bladder-, bowel- and sexual functioning after treatment. When the morbidity of the treatment is high and life after treatment is long, loss of quality of life (QoL) is an important aspect. Hereby, more and more attention is focused on tailored treatment, finding the optimal balance between good survival results with maintenance of QoL. The aim of this thesis was to investigate the role of radicality of surgery and the resultant impact on tumour control, survival and morbidity. Collaborated work between oncological centers in the Netherlands made it possible to conduct a series of studies finding answers to the importance of the extent of surgery and morbidity and QoL after treatment