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Radical hysterectomy and pelvic lymphadenectomy for early invasive cancer of the cervix — 14-year experience
  1. V. Sivanesaratnam*,
  2. D. K. Sen,
  3. P. Jayalakshmi and
  4. G. Ong§
  1. * Departments of Obstetrics and Gynecology,
  2. Pathology, and
  3. § Anaesthesiology, University of Malaya, Kuala Lumpur, Malaysia
  4. Department of Obstetrics and Gynecology, National University of Singapore, Singapore>
  1. Address for correspondence: Professor V. Sivanesaratnam, Department of Obstetrics & Gynecology, Faculty of Medicine, University of Malaya, 59100 Kuala Lumpur, Malaysia.


During a 14-year period, 397 radical hysterectomies and pelvic lymphadenectomies were performed for early invasive carcinoma of the cervix. Twenty-one patients were in stage IA2 with lymphatic/vascular channel permeation (5.2%), 340 in stage IB (85.6%) and 34 in early stage 2A disease (8.5%). Eighteen patients (4.5%) were pregnant. Adenocarcinoma comprised 26.9% of cases. The mean operative time was 4.14 h; the intraoperative blood loss was less than 1.51 in 77.3% patients. There was no operative mortality; one patient died 3 weeks after surgery from clostridium difficile enterocilitis. Eleven patients (2.7%) developed venous thrombosis; severe lymphedema occurred in four (1%). The incidence of uretero-vaginal fistula was 0.2% and that of vesico-vaginal fistula 0.5%. Ovarian metastases were noted in 4.3% of cases with adenocarcinoma. Sixty-six patients had positive nodes (16.6%). Five-year survival in patients with more than 2 positive nodes was 68%. The use of adjuvant chemotherapy in patients with ‘high risk’ factors resulted in survival rates approaching those without risk factors. Neo-adjuvant chemotherapy was used in 10 patients with large bulky tumors; the results were favorable. Recurrences occurred in 47 patients (11.8%); 36 patients have died (9.1%). Age did not appear to influence survival. The overall 5-year survival was 92.2%.

  • early invasive cervical carcinoma
  • radical hysterectomy.

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