Carcinoma of the uterine cervix stage I and IIA: results of surgical treatment: complications, recurrence and survival.

Between 1967 and 1981, 213 patients with carcinoma of the uterine cervix Stage I and IIA underwent an abdominovaginal radical hysterectomy with transperitoneal lymphadenectomy. In 1987 the overall 5-year survival rate was 87.5% and the 10-year survival 85%. Recurrences were seen in 29 patients (13.7%). Lymph node metastases occurred in 39 patients (18%). Five-year survival decreased from 94% without positive nodes to 65% with positive nodes. The median blood loss was 2100 cc. Fistulas were seen in 6.7% of the patients. Long-term voiding problems were encountered in 40.8%. In 25% of the women intercourse was impeded postoperatively because of shortening of the vagina. The results obtained with this type of radical surgery in cervical cancer Stages I-IIA are good and do not differ from other methods reported in the literature. However this also means that this more difficult and time-consuming approach does not improve survival rates. For this reason there are no reasons to change from the Wertheim operation to this combined approach.