OBJECTIVE: There are no randomized studies of the two therapeutic alternatives (surgery or radiotherapy) for occult cervical carcinoma, and survival rates in the absence of residual cancer seem to be similar for both. This article presents our experience with radical reoperation for occult cervical carcinoma. MATERIALS AND METHODS: Eleven patients with occult cervical cancer, primary invasive tumor >/=0.5 cm and </=3.0 cm, free margins in the hysterectomy specimen, and absence of clinically evident residual tumor were reoperated (radical parametrectomy with partial colpectomy and pelvic lymphadenectomy). RESULTS: Histopathologic examination after reoperation showed no evidence of residual disease in nine cases and metastasis in lymph nodes in two cases, one of them with parametrial involvement. Survival was 100% among disease-free cases on reoperation and 0% in cases with residual disease (5-year follow-up). CONCLUSIONS: Radical reoperation allows disease staging, sorting of patients into risk groups, and avoidance of radiation therapy in more than two thirds of the cases of occult cervical carcinoma.
OBJECTIVE: There are no randomized studies of the two therapeutic alternatives (surgery or radiotherapy) for occult cervical carcinoma, and survival rates in the absence of residual cancer seem to be similar for both. This article presents our experience with radical reoperation for occult cervical carcinoma. MATERIALS AND METHODS: Eleven patients with occult cervical cancer, primary invasive tumor >/=0.5 cm and </=3.0 cm, free margins in the hysterectomy specimen, and absence of clinically evident residual tumor were reoperated (radical parametrectomy with partial colpectomy and pelvic lymphadenectomy). RESULTS: Histopathologic examination after reoperation showed no evidence of residual disease in nine cases and metastasis in lymph nodes in two cases, one of them with parametrial involvement. Survival was 100% among disease-free cases on reoperation and 0% in cases with residual disease (5-year follow-up). CONCLUSIONS: Radical reoperation allows disease staging, sorting of patients into risk groups, and avoidance of radiation therapy in more than two thirds of the cases of occult cervical carcinoma.