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

  • Angeline Gnanamalar
  • Abraham Peedicayil
  • Ajit Sebastian
  • Vinotha Thomas
  • Anitha Thomas
  • Rachel ChandyEmail author
Original Article

Abstract

Background

Cervical 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.

Methods

All 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.

Results

The mean age of the patients was 53 years (SD 10) with a range of 33–77 years. Most tumours were squamous cell carcinomas (78%) and stage IB1 (72%). Most tumours (84%) were smaller than 4 cm 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 3 years and 74% at 5 years. The overall survival was 89% at 3 years, 84% at 5 years and 79% at 10 years.

Conclusions

Radical hysterectomy can cure the majority of patients with early cervical cancer. Patients with stages IB2 and IIA have significantly more recurrence and less survival.

Keywords

Cervical cancer Radical hysterectomy Complications Survival 

Notes

Funding

Research Funds from CMC Hospital, Vellore, are gratefully acknowledged

Compliance with Ethical Standards

Conflict of interest

None of the authors have any conflict of interest.

Informed Consent

This study was approved by our institutional review board. Since this was a retrospective chart review, informed consent from patients was waived.

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Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  • Angeline Gnanamalar
    • 1
  • Abraham Peedicayil
    • 1
  • Ajit Sebastian
    • 1
  • Vinotha Thomas
    • 1
  • Anitha Thomas
    • 1
  • Rachel Chandy
    • 1
    Email author
  1. 1.Department of Gynaecologic OncologyCMC HospitalVelloreIndia

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