Radical reoperation for invasive cervical cancer found in simple hysterectomy

To evaluate the patients with invasive cervical cancer found in simple hysterectomy and who were subjected to radical parametrectomy and upper vaginectomy with therapeutic lymphadenectomy.

Twenty-seven patients who underwent the radical parametrectomy and upper vaginectomy with therapeutic lymphadenectomy procedure from 1986 to 2004 were retrospectively reviewed.

The mean age at the time of diagnosis was 49.85 (range 38-72). The histopathological diagnoses were SCC, adenocarcinoma, adenosquamous carcinoma, endometroid carcinoma, and anaplastic carcinoma in 70.4%, 11.4%, 7.4%, 7.4%, and 3.7% of patients, respectively. Operative complications occurred in only five patients (18.5%). Following radical surgery, residual disease was found in 10 patients (37.03%). The lymph node involvement rate was 22.2% (6 patients). The recurrence rate was 7.4% (2 of 27 patients). The overall disease-free survival rate was 88.67%. The overall survival rate was 88.89%; it was significantly lower in the presence of the following factors: anaplastic carcinoma, vaginal apex metastasis, and pelvic lymph node metastasis.

This series suggests the excellent overall survival of patients that underwent radical surgery. We recommend the surgical treatment of such selected patients in experienced centers only with expert surgeons and primary adjuvant radiotherapy may be recommended in selected patients.