{"entity":{"id":"paper-shape-nejm-2024","kind":"paper","name":"SHAPE: simple versus radical hysterectomy in low-risk early cervical cancer","aka":[],"tldr":"For small, low-risk cervical cancers, a simple hysterectomy gave the same very low pelvic recurrence rate as a radical hysterectomy with fewer urinary and sexual complications, so less extensive surgery is now acceptable.","summary":"Phase 3 non-inferiority trial of 700 women with low-risk cervical cancer (up to 2 cm, limited stromal invasion) randomised to simple hysterectomy or radical hysterectomy, both with pelvic node assessment.\n\nThree-year pelvic recurrence was 2.52 percent with simple hysterectomy and 2.17 percent with radical hysterectomy, within the non-inferiority margin, with fewer urinary incontinence and retention problems and better sexual health after simple hysterectomy.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2024","url":"https://doi.org/10.1056/NEJMoa2308900"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/38416430/"}],"tags":[],"related":[],"cancers":["early-cervical-cancer"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["shape"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2024,"doi":"10.1056/NEJMoa2308900","pmid":"38416430","authors":"Plante M, Kwon JS, Ferguson S, et al.","paperType":"rct","findings":["Three-year pelvic recurrence 2.52 percent vs 2.17 percent (non-inferior).","Urinary incontinence 2.4 percent vs 5.5 percent within four weeks; urinary retention 0.6 percent vs 11.0 percent."],"whatItMeans":"Women with low-risk early cervical cancer can be offered simple hysterectomy, sparing them the bladder and sexual morbidity of parametrectomy, provided strict eligibility criteria are applied.","caveats":["Strict imaging and pathology criteria define low risk; misapplication to larger tumours would be unsafe.","Longer follow-up is pending."],"changedPractice":true,"participants":700},"route":"/key-papers/paper-shape-nejm-2024/","neighbours":{"cancer":[{"id":"early-cervical-cancer","kind":"cancer","name":"Early cervical cancer and fertility-sparing surgery","route":"/cancers/early-cervical-cancer/"}],"trial":[{"id":"shape","kind":"trial","name":"SHAPE (CCTG CX.5)","route":"/trials/shape/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}