Landoni 1997.

Study characteristics
Methods	Randomised controlled trial 1986 to 1991; Milan, Italy
Participants	337 patients with stage IB or IIA cervical cancer: 46 with cervical adenocarcinoma
Interventions	Surgery consisted of a Class III radical abdominal hysterectomy n + 26. Adjuvant radiotherapy was given if at least 1 pathological risk factor (stage > pT2a, less than 3 mm uninvolved stroma, cut through, lymph‐node metastases) Radiotherapy included external beam pelvic irradiation plus brachytherapy. Total dose at point A ranged 70 to 90 Gy (median 76 Gy) N = 20.
Outcomes	5‐year overall survival: 70% after primary surgery (N = 26) versus 59% after primary radiotherapy (N = 20). No evidence of disease at 5 years: 66% after surgery versus 47% after radiotherapy Complications surgery‐related 28%, radiation‐related 12% For patients with cervical adenocarcinoma, the 20‐year overall survival: 71% and 47% for surgery and radiotherapy respectively.
Notes	‐
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk
Allocation concealment (selection bias)	Low risk
Blinding (performance bias and detection bias) 5 yr survival	High risk	In the follow‐up primary therapy was obvious
Blinding (performance bias and detection bias) complications	High risk
Incomplete outcome data (attrition bias) All outcomes	Low risk
Selective reporting (reporting bias)	Low risk
Other bias	Low risk