Cervical cuff carcinoma: causes and prevention

Over an 11-year period (1990-2000) a total of 59 patients with cervical cuff carcinoma were hospitalized (I stage--17; II stage--30; III-IV stage--12 patients). Seventeen patients were subjected to radical extirpation with lymphadenectomy for cervical cuff carcinoma, while 42 patients received combined radiotherapy. In the last 20-year period the patients had undergone supravaginal amputation of the uterus due to uterine fibromyoma, polyposis, and ovarian tumors in various gynecological clinics. In 12 patients the onset of cervical cuff carcinoma occurred within one year after supravaginal amputation of the uterus; in another six patients cancer developed within two years postoperatively, 15 patients in a 3 to 9 year period and 26 developed cancer 10-20 years after surgery. It seems in fact that when cervical cuff carcinoma developed within one year after supravaginal amputation of the uterus the patients had cervical carcinoma which was not identified due to physician negligence. In cases of latent periods up to ten years the patients must have had at least pre-existing disease. To prevent development of cervical cuff carcinoma in the future when operating on the uterus and/or adnexa the scope of surgery (extirpation, amputation) shall be decided based on colposcopic examination of the cervix (target cytology).