ABSTRACT
Objective: Surgical management of cervical carcinoma by radical hysterectomy [Type III] has been proven a highly effective method in treating early stage disease. The purpose of this study was to evaluate the efficacy and safety of modified [Type II] radical hysterectomy for treatment of early stage [I-IIa] cervical carcinoma
Methods: A retrospective analysis on data of 47 patients with cervical carcinoma treated by modified radical hysterectomy during the period 1985 till 1996 with a FIGO clinical stages as la [11], Ib [29], and Ha [7]. 20 patients had radiotherapy in addition to surgery, 11 preoperative and 9 post operative. Patients had a mean follow up period of 91 month [21 -160]
Results: The surgical margins particularly the parametrial were adequate and free of malignancy in all the specimens whereas, the mean tumor size was 3cm [0.4-7], the mean depth of invasion was 9mm [1-18], and 6[12.8%] of patients had pelvic LN metastases. Two cases had parametrial extensions and 9 had vaginal extensions. Six patients [12.7%] developed relapses after a mean follow-up time of 26.5months postsurgery with no central pelvic recurrence. The 5-year disease free survival was 90.3% and the 10-year disease free survival was 87%. Cases with lesions 4cm or less in size [38] had one relapse only [2.5%] and lesions with depth less than 10mm showed no relapses
Conclusions: Modified radical hysterectomy appears to be equivalent to radical hysterectomy for lesions 4cm or less in size, but for larger sizes preoperative chemo-irradiation must be considered if conservative surgery is attempted