The prognosis of patients with locally advanced cervical cancer undergoing surgical versus non-surgical treatment: a retrospective cohort study based on SEER database and a single-center data.

The aim of this study was to investigate the impact of surgical treatment on the survival prognosis of patients with locally advanced cervical cancer (LACC) and to identify factors that may influence the efficacy of surgery. Data from the SEER database (2000-2020) and a hospital (2013-2023) were collected for this investigation. Utilizing multivariable Cox regression analysis, Kaplan-Meier survival analysis, and log-rank tests, we assessed the effects of surgical intervention on overall survival (OS) and disease-specific survival (DSS) in LACC patients. Our results revealed that in the SEER database, the surgical group exhibited significantly better OS and DSS compared to the non-surgical group. Particularly noteworthy was the significantly higher survival rate in the surgical group for patients with tumor diameters less than 6 cm. Furthermore, both OS and DSS were improved in the surgical group regardless of whether the cancer was squamous cell carcinoma or adenocarcinoma. Additionally, patients who underwent surgery combined with radiotherapy had notably better OS and DSS compared to those who received chemoradiotherapy alone. Similarly, our hospital data showed that the surgical group demonstrated significantly better OS than the non-surgical group, especially for patients with tumors smaller than 6 cm in diameter. These findings suggest that surgery combined with radiotherapy may offer more favorable outcomes than chemoradiotherapy alone, particularly for LACC patients with smaller tumors.