Aim: The aim of this study was to determine the outcome of class II radical hysterectomy for the treatment of a subset of patients with early cervical cancer.

Method: From September 1995 to September 2003, a total of 480 patients whose conditions were diagnosed with squamous carcinoma of the cervix with a tumor size of no greater than 2 cm and a pathological grade 1 to 2 was enrolled in a cohort study to compare class II and class III radical hysterectomy, with 240 patients in each group. Disease-free survival, overall survival, pattern of recurrences, and morbidity were the end points of observation for this study.

Results: The class II surgery group had 100.0% overall and 98.33% disease-free actuarial 5-year survival rate, whereas the class III surgery group had 100.0% overall and 97.92% disease-free actuarial 5-year survival rate (P = 0.736). Recurrence rate (2.92% in class II vs 2.50% in class III) was not significantly different in the 2 groups (P = 0.779). The operating time, postoperative length of hospital stay, and estimated blood loss at surgery were significantly lower in the group of patients who underwent class II hysterectomy (P = 0.0001, P = 0.0001, and P = 0.001, respectively). The postoperative complications were also significantly lower in patients who received class II hysterectomy.

Conclusions: In treating a subset of patients with tumor size no greater than 2 cm and grade 1 to 2 squamous cell cancer, class II and class III radical hysterectomy are equally effective, but the former has far less complications than the latter.