Radical hysterectomy and pelvic lymphadenectomy for carcinoma of the uterine cervix (original) (raw)
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Radical hysterectomy and pelvic lymphadenectomy for carcinoma of the cervix
Cancer
patients with carcinoma of the cervix were treated a t the National Cancer Institute with radical hysterectomy and bilateral pelvic lymphadenectomy. A total cumulative 5-year survival of 83.5% was obtained. Fourteen patients classified as failures to previous radiotherapy, with a 5-year survival of 8596, were in this group. Nine patients with adenocarcinoma survived at a rate similar to the patients with epidermoid carcinoma. Despite excision of all paracervical tissue en bloc and the taking of 3-to 5-cm vaginal cuff, the local recurrence rate was 14%. T h e cause of tumor death was most often related to the combination of local recurrence and metastases. I n patients with negative pelvic nodes, the 5-year survival was 91% while in the presence of positive pelvic nodes the 5-year survival was 66%. T h e in-hospital mortality rate was 2.7%. No patient was lost to follow-up. Complications in this series where one third of the patients had been treated previously with irradiation or surgery were related primarily to the urinary tract, with a n 8 % incidence of urinary fistulae, 7% incidence of ureteral stricture, and 8% incidence of atonic bladder. Radical hysterectomy is admittedly a technically difficult operation but the complications can be minimized with proper patient selection, and survival may be obtained which is equal to, or superior to, other reported treatment modalities. ROM 1954 to 1969, OVER 2,000 PATIENTS
Unexpected encounters challenging modified radical hysterectomy
International Journal of Clinical Obstetrics and Gynaecology
The intention of this study is to educate and caution young surgeons about the possibility of stumbling into anatomical anomaly while operating for cancer cervix. Methods: This is an observational study, reflecting the numbers of congenital anomalies that were encountered while doing hysterectomy for cancer cervix in a tertiary care hospital within a 16 years span. Results: This study revealed the overall prevalence of congenital anomalies while performing hysterectomy for cancer cervix to be 2.9% and double ureter to be most common anomaly encounterd. Conclusion: Anatomical anomalies pose challenges when encountered while operating for cancer cervix. Surgical methods and dissections need to be planned accordingly to protect urinary pathways and vessels, that should be kept in mind particularly by low volume surgeons. Surgery can be disastrous if they is not recognized prior to procedure.
Chinese journal of cancer research = Chung-kuo yen cheng yen chiu, 2016
The radical hysterectomy (RH) surgical technique has improved along the years. It is used for the treatment of cervical cancer, endometrial cancer when affecting the cervix, and upper vaginal carcinomas. Our aim was to describe the historical evolution of the technique after the introduction of laparoscopy at our institution. We performed a retrospective review of medical records of patients who underwent RH, grouped in three periods according to the year of surgery: 1990-1999, 2000-2009 and 2010-2013. Patients?characteristics, pathologic details, intraoperative and postoperative complications were analyzed and compared throughout the time periods. A total of 102 cases of RH were performed at our center during the study period. Among all data collected, the presence of necrosis, age, number of lymph nodes, surgery route, operating time, hospital stay, blood loss and transfusion requirement were statistically significant different among groups. Conversion to laparotomy rate was 19% f...
‘State of the art’ of radical hysterectomy; current practice in European oncology centres
European Journal of Cancer, 2004
Quality control of medical performance requires adequate 'state-of-the-art' data and this is currently not uniformly defined for radical hysterectomy. We have used data from a randomised multicentre clinical trial examining the clinical significance of surgical drains following radical hysterectomy (European Organisation for Research and Treatment of Cancer (EORTC)-55962). Although the study was not designed to analyse the quality of the surgical procedure per se, surgical data during and after the operation were carefully noted. A total of 234 patients from 12 European institutes were included in the study. We reported on the clinical and surgical characteristics, the radicality of surgery and short-and long-term complications of radical hysterectomy: median duration of surgery: 240 min; median number of nodes removed: 26; lymph node metastases: 22%; post-operative mortality: < 1%; urinary tract infection: 42%; deep venous thrombosis: 3%; fistula: 2%. The data from our study provides an honest and realistic picture of the current practice of radical hysterectomy among European oncology centres and may be considered as the 'standard of care' in this part of the world.
International Journal of Research in Medical Sciences, 2017
Background: Early invasive invasive carcinoma of cervix is adequately treated by surgery,radiotherapy or by combination of both.The disease-free and overall survival varies from centre to centre. Recurrence of the disease is a reflection of failure in treatment.Methods: A total of 541 cases of Radical hysterectomy with pelvic lymphadenectomy, for early stage cancer cervix performed during the period 2006 April - 2017 March at A. H. Regional Cancer Centre Cuttack, were retrospectively analysed, with an objective to identify the risk factors responsible for treatment failure. All cases were followed-up for 5 years or more.Results: Radiotherapy was supplemented in 27% of cases. Recurrence occurred in 17.18% cases. The incidence of recurrence increased from 13.9% in Stage IB to 26.3% in Stage IIB. Younger patients showed a higher recurrence of 19.16% compared to older group. Poorly differentiated squamous cell carcinoma showed 15.9% recurrence and adenocarcinoma showed 15.38% recurrence...
Radical hysterectomy in the elderly
World Journal of Surgical Oncology, 2008
Background The considerable increase in life expectancy on one hand and an increase in cervical cancer among Iranian patients on the other, brings out the importance of investigating whether radical surgery can be performed safely and effectively on patients above 60 years of age. Methods In a study of historical cohort, all 22 patients 60 years and above who have undergone a Wertheim radical hysterectomy for cervical cancer from 1999 to 2005 were compared with 128 matched cases under 60 years of age who had undergone a Wertheim hysterectomy during the same calendar year. All patients were analyzed for preexisting medical comorbidities, length of postoperative stay, morbidity, and postoperative mortality. Results There was no operative mortality in either group, morbidity (minor, p = 0.91; major, p = 0.89) were statistically not different in the two groups despite the patient's above 60 years having significantly higher comorbidity prior to surgery than the younger cohort (minor...
Hysterectomy: retrospective analysis of 476 cases
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Diseases of the female genital tract are commonly encountered in clinical practice. Hysterectomy is the definite treatment for many of the pelvic pathologies. The present study is aimed at analysis of age and types of hysterectomy and evaluation of histopathological reports of the hysterectomy specimens.Methods: A total of 476 consecutive hysterectomy were studied over a period of two years from January 2016 to December 2017.Results: The peak age group of hysterectomy was 41-50 years with 221 (46.43%) cases. The commonest type of hysterectomy was abdominal. The most common endometrial pathology was atrophic endometrium, seen in 131 (27.52%) cases. In myometrium, the most common pathology was leiomyoma in 179 (37.61%) cases. Among cervical lesions, chronic cervicitis was the most common finding, seen in 274 (57.56%) cases.Conclusions: The experience with various types of hysterectomies at our institution has been reviewed. A wide spectrum of lesions were observed when his...