Class II radical hysterectomy shows less morbidity and good treatment efficacy compared to class III

Treatment of 102 patients with cancer of the cervix by class II and III radical hysterectomy was reviewed to compare the operative morbidity and efficacy of class II radical hysterectomy for select cases. Of the 102 patients, 21 had a class II hysterectomy, whereas 81 patients had a class III hysterectomy. The class II operation was performed for those subjects in whom invasive cancer beyond microinvasion could not be excluded after a cone biopsy. The mean age and weight of women having class II and III radical hysterectomies were nearly identical (41.1 and 40.6 years, respectively, and 66 and 65 kg, respectively). However, the mean operative time (3.8 and 4.7 hr, respectively; P = 0.001) and postoperative hospital stay (7.3 and 9.2 days, respectively; P = 0.001) were lower for class II than for class III hysterectomies. No fistulas or recurrent cancer developed following class II hysterectomy, and no patients had metastatic cancer in the nodes or parametrium. Among the 81 women undergoing class III hysterectomy, there were 3 fistulae and 3 recurrences. We conclude that the lesser morbidity, including shorter operative time and shorter postoperative hospital stay and excellent cancer control of the class II radical hysterectomy and lymphadenectomy, recommend the operation for selected early cancers of the cervix especially when a question concerning depth of invasion exists after cone biopsy.