Indication, Technique, and Outcome of Super-Radical Hysterectomy for Cervical Cancer

Abstract

Mibayashi invented super-radical hysterectomy, and his operative method was intended for radical surgery in patients with stage IIIB cervical cancer. However, the combination of intracavitary and external radiation currently provides a good outcome with good quality of life in patients with advanced cervical cancer. However, the survival rate of patients with stage IIIB cancer is approximately 50–65%, and further efforts to improve the outcome should be continued. As described by Mibayashi himself, a parametrial lymph node metastasis fixed to the origin of the cardinal ligament can be identified at laparotomy in some patients with clinical stage IB–IIB disease, and super-radical hysterectomy is a useful surgical approach in such patients. Regarding the safety of this operative method, because the internal iliac vessels can be clearly visualized after lymph node dissection during current curative surgery for cervical cancer, it is possible to perform super-radical hysterectomy safely. Although super-radical hysterectomy is not a surgical procedure of routine use for cervical cancer, it is an important operative method that should be used in a flexible manner as indicated, depending on the tumor findings at laparotomy.