Surgical outcomes of patients with early cervical cancer treated with radical hysterectomy in a tertiary care hospital
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20210716Keywords:
Radical hysterectomy, Cervical cancer, Surgical managementAbstract
Background: This study was undertaken to evaluate the surgical outcomes of patients with early cervical cancer treated with radical hysterectomy.
Methods: A total of 50 patients who underwent modified radical hysterectomy between April 2006 and April 2016 at Shri Dharmasthala Manjunatheswara medical college and hospital, Dharwad, Karnataka were retrospectively reviewed. The analysis included clinical and pathologic variables including age, tumour size, clinical stage, lymphovascular space involvement, tumour type and grade, lymph node metastases, surgical margin involvement, intraoperative and postoperative complications and pattern of adjuvant therapy were analysed.
Results: The median age of the patient who underwent radical hysterectomy was 47.8 years, the mean parity being 3.6. Histologically, the most common type of malignancy encountered was squamous cell carcinoma of the cervix, which occurred in 42 patients (84 %). 8 (16%) showed involvement of 1 or more lymph nodes and evidence of lymphovascular invasion. Involvement of the resected vaginal margins was noted in 11 patients (22%). The average hospital stay was 19.8 days, the prolonged stay resulting from postoperative morbidity. Postoperative concurrent chemoradiation with cisplatin was administered in eight (16%) cases due to pelvic lymph node metastases. Postoperative vaginal brachytherapy was given in 11 (22%) cases because of positive vaginal margins.
Conclusions: The present study shows that general gynaecologists with significant experience in general gynaecologic surgery may, with adequate but abbreviated training, become competent in performing a modified radical hysterectomy.
References
National Cancer Registry Programme, Globocan 2012. Available at: http://www.globocan.iarc.fr. Accessed 20 Nov 2020.
Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstetr. 2009;105(2):103-4.
Sevin BU, Nadji M, Averette HE, Hilsenbeck S, Smith D, Lampe B. Microinvasive carcinoma of the cervix. Cancer. 1992;70(8):2121-8.
Michalas S, Rodolakis A, Voulgaris Z, Vlachos G, Giannakoulis N, Diakomanolis E. Management of early-stage cervical carcinoma by modified (type II) radical hysterectomy. Gynecol Oncol. 2002;85(3):415-22.
Ayhan A, Tuncer ZS, Yarali H. Complications of radical hysterectomy in women with early-stage cervical cancer: clinical analysis of 270 cases. Eur J Surg Oncol. 1991;17:492-4.
Powell JL, Ross SC, Henderson GS. Radical hysterectomy and pelvic lymphadenectomy at a community teaching hospital. J Gynecol Surg. 2003;19(3):129-31.
Olatunji AO, Adefuye PO, Jagun EO, Oloruntoba AR. Radical (Wertheim) hysterectomy for early stage (1B and 2A) cancer of the cervix. Niger Med Pract. 2006;50(2):33-5.
Gharoro EP. Surgical management of early stages of cervical cancer: the value of internal iliac artery ligation. J Obstet Gynaecol. 2003;23(1):44-7.
Yuvaraja TB, Wuntakal R, Maheshwari A, Kerkar RA, Tongaonkar HB. Management and long-term follow-up of ureteric injuries during radical hysterectomy: single center experience. J Gynecol Surg. 2003;19(3):133-9.
Likic IS, Kadija S, Ladjevic NG, Stefanovic A, Jeremic K, Petkovic S et al. Analysis of urologic complications after radical hysterectomy. Am J Obstet Gynecol. 2008;199(6):644.
Cai H-B, Chen H-Z, Zhou Y-F, Lie D-M, Hou H-Y. Class II radical hysterectomy in low-risk ib squamous cell carcinoma of cervix: a safe and effective option. Int J Gynecol Cancer. 2009;19(1):46-9.
Ayhan A, Tuncer ZS, Yarali H. Complications of radical hysterectomy in women with early-stage cervical cancer: clinical analysis of 270 cases. Eur J Surg Oncol.1991;17:492-4.
Pikaart DP, Holloway RW, Ahmad S. Clinical-pathologic and morbidity analyses of types 2 and 3 abdominal radical hysterectomy for cervical cancer. Gynecol Oncol. 2007;107(2):205-10.
Takeda N, Sakuragi N, Takeda M, Okamoto K, Kuwabara M, Negishi H et al. Multivariate analysis of histopathologic prognostic factors for invasive cervical cancer treated with radical hysterectomy and systematic retroperitoneal lymphadenectomy. Acta Obstet Gynecol Scand. 2002;81(12):1144-51.
Ackermann S, Beckmann M. Accuracy of cervical cancer staging needs improvement. Am J Obstet Gynecol 2005;192(2):659-60.
