Factors affecting operative blood loss from open radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer

To evaluate the effect of clinical and tumor factors on operative blood loss during open radical hysterectomy and pelvic lymphadenectomy for early-stage cervical cancer. Clinical, pathological, and operative data of 456 women with cervical cancer stage IA2-IIA who had open radical hysterectomy with bilateral pelvic lymphadenectomy (RHPL) from January 2003 to December 2005 were reviewed with regard to operative blood loss of 600 ml or more. Parity (RR 1.67; 95 % CI 1.02-2.73; p value 0.04) and salpingo-oophorectomy (RR 1.57; 95 % CI 1.06-2.31; p value 0.02) were statistically associated with operative blood loss of 600 ml or more from multivariate analysis. Preoperative chemotherapy (RR 1.87; 95 % CI 1.18-2.96; p value < 0.01) and BMI a parts per thousand yen 25 kg/m(2) (RR 1.73; 95 % CI 1.08-2.75; p value 0.02) were significantly associated with blood loss of more than 1,000 ml in the multivariate analysis. High parity (3 or more) and incidental salpingo-oophorectomy are related to an increased risk of operative blood loss of 600 ml or more during open RHPL. However, the effects were marginal and no clear explanation for the underlying mechanisms is available. Preoperative chemotherapy and overweight were independent predictors of operative blood loss of more than 1,000 ml.