The Surgical and Oncological Outcomes of Radical Hysterectomy for Early Cervical Cancer

BackgroundCervical cancer is the second most common cancer among women in incidence and mortality in India. Early cervical cancer is treated primarily by radical hysterectomy where the ovaries may be preserved. The aim of this study was to report the complications and survival outcomes of radical hysterectomy.MethodsAll 61 patients who underwent modified radical or radical hysterectomy for early-stage cervical cancer in the Department of Obstetrics and Gynaecology at a tertiary-level teaching hospital, between 2001 and 2010, were included. Patients who received neoadjuvant treatments were excluded. Clinical details were obtained from discharge summaries and medical records, both paper and electronic.ResultsThe mean age of the patients was 53years (SD 10) with a range of 33-77years. Most tumours were squamous cell carcinomas (78%) and stage IB1 (72%). Most tumours (84%) were smaller than 4cm in size. There were no perioperative deaths. The most common complications were urinary tract infections in 29% and voiding dysfunction in 23%. Injuries occurred in seven patients (11.5%): three ureters, three iliac vessels and one bowel. Blood transfusion rate was 31%. High risk factors were present in 14 patients (23%) and at least two intermediate risk factors in eight patients (13%). Adjuvant radiation therapy was given in these 22 patients. Seven patients were lost to follow-up. Recurrence occurred in ten patients and death occurred in eight patients, of whom disease was documented in seven. The recurrence-free survival was 79% at 3years and 74% at 5years. The overall survival was 89% at 3years, 84% at 5years and 79% at 10years.ConclusionsRadical hysterectomy can cure the majority of patients with early cervical cancer. Patients with stages IB2 and IIA have significantly more recurrence and less survival.