[Status of surgery in therapy of cervix cancer]

Between 1969 and 1980 296 patients with cervical cancer were treated by surgery in our department and some were given postoperative irradiation. The five-year survival rate was 96.2% in stage I a cases and 85.2% in stage Ib. The surgically obtained specimens were evaluated for tumour extension and lymph node spread. These parameters were examined for their prognostic value. The tumour size correlated with the five-year survival rate. Lymph node spread was found in 1% of stage Ib cases. Intraoperative complications were seen in 2.4% of patients. Postoperative complications appeared in 44%. Late complications were found in 19.1%. Diagnostic conisation is of predominant value for the adequate surgical management of cervical cancer stage Ia and borderline stage Ib cases. Our own results and comparable data of other authors allow the following guidelines to be laid down for the operative treatment of early invasive cervical cancer: In stage I a: When the tumour volume is less than 1 mm3 (early stromal invasion according to Lohe) simple hysterectomy (in special cases possible only conisation) is sufficient. Microcarcinoma (tumour size less than 10 X 10 X 5 mm) is best treated by the conventional Wertheim operation. When tumour invasion of blood or lymph vessels is diagnosed, additional lymphadenectomy must be performed. In stage Ib-IIa: Radical operation according to the Latzko technique is advisable.