A. Both treatment strategies for stage Ib and early-stage Ila invasive carcinoma include 1) a primary surgical approach with radical hysterectomy and pelvic lymphadenectomy or 2) primary radiation therapy with external beam radiation and either high-dose-rate or low-dose-rate brachytherapy. The 5-year survival rate is 87-92% using either approach.
B. Radical surgery leaves the vagina in more functional condition, while radiation therapy results in a reduction in length, caliber, and lubrication of the vagina. In premenopausal women, ovarian function can be preserved with surgery. The surgical approach also provides the opportunity for pelvic and abdominal exploration and provides better clinical and pathologic information with which to individualize treatment.
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