Radical hysterectomy as therapy for early carcinoma of the cervix

During a 13-year period, 268 radical hysterectomies and pelvic lymphadenectomies were performed for Stage IB and IIA carcinoma of the cervix at Duke University Medical Center. Fifteen percent of patients had lymph node metastasis. Substage, histologic features, grade, capillary-like space involvement, and lesion size did not appear to affect nodal status. Survival was related to lymph node metastasis, status of surgical margins, and lesion size. Judicious use of radiation therapy after hysterectomy may have improved survival in high-risk patients. These does not appear to be any contraindication to operation in this group of patients as long as the condition is deemed medically operable.