The vaginal radical operation of cervical cancer

Choosing the surgical technique for the cervix carcinoma--vaginal or abdominal--it is particularly necessary to take into account the lymphatic spread of the cervix. As it is not possible to realize a lymphadenectomy in a vaginal procedure, it has to be found a preoperative diagnostic method which enables very surely the exclusion of lymph node involvement. In summary of the facts stated up to now, one can conclude as follows: 1. The FIGO-classification is too subjective. 2. There is a significant correlation between tumor volume and lymph node involvement. 3. The tumor markers--as e.g. PCNA, p53, c-neu, EGF, beta 1 Integrin etc.--show no correlation with the lymph node involvement. 4. Only MRI allows an exact preoperative measurement of the tumor volume. 5. On account of the above mentioned results, it seems to be possible to extend the indication for the vaginal radical surgery on cases with a small tumor volume.