{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:43:37Z","timestamp":1785908617486,"version":"3.56.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surgical management of early-stage cervical cancer has evolved substantially over the past decade. While the LACC trial raised concerns regarding minimally invasive radical hysterectomy, real-world practice continues to include radical, non-radical, and fertility-sparing approaches. This study evaluated operative strategies and temporal trends in Germany, particularly regarding the impact of the LACC trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicenter study included 391 patients with early-stage cervical cancer (\u2264pT1, pN0, FIGO &amp;lt; IB1) treated at four German university hospitals between 2014 and 2024. Demographic, surgical, perioperative, oncologic, and follow-up data were analyzed descriptively, focusing on temporal changes in surgical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age at diagnosis was 44 years, and 95.9% of patients had an ECOG performance status of 0\u20131. Pathological staging revealed pT1b1 tumors in 56.0% of cases, while microinvasive disease (pT1a1\u2013a2) accounted for 35.3%. Laparoscopic approaches declined from 66.5% before 2019 to 50.0% thereafter following publication of the LACC trial in 2018 (p &amp;lt; 0.001), with a corresponding increase in open surgery. Fertility-sparing procedures remained stable (conization 11.3%, trachelectomy 7.4%). Perioperative morbidity was low, with no postoperative complications in 84.4% of patients. Disease recurrence occurred in 5.9% of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This multicenter study provides a comprehensive overview of contemporary surgical management of early-stage cervical cancer in Germany. Surgical practice changed substantially over time, likely reflecting the combined influence of emerging clinical evidence, evolving guideline recommendations, and changing treatment paradigms; however, no uniform operative standard has emerged. Favorable perioperative and oncologic outcomes across approaches highlight the importance of patient selection and surgical expertise in contemporary cervical cancer care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1916573","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:43:20Z","timestamp":1785905000000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of the temporal changes in management of early-stage cervical cancer over a 10-year period in Germany: a multicenter retrospective analysis of the JAGO\/NOGGO"],"prefix":"10.3389","volume":"16","author":[{"given":"Lena","family":"Steinkasserer","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa 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Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Hertel","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Hannover Medical School","place":["Hannover, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Flethe","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charite-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin Institute of Health","place":["Berlin, Germany"]},{"name":"Young Academy of Gynecologic Oncology (JAGO), North-Eastern German Society of Gynecologic Oncology (NOGGO)","place":["Berlin, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Pietzner","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Center for Oncological Surgery, Campus 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