RADICAL HYSTERECTOMY IN SURGICAL TREATMENT OF INVASIVE CERVICAL CANCER AT THE DEPARTMENT OF GYNECOLOGY AND OBSTETRICS IN NOVI SAD IN THE PERIOD 1993-2013.

Abstract

During the period from 1993 - 2013, 175 women with invasive cervical cancer underwent radical hysterectomy sec. Wertheim-Meigs at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Indications for radical hysterectomy comprise histopathologically confirmed invasive cervical cancer in stages I B 1- II B according to the International Federation of Gynecology and Obstetrics. Stage ofthe disease or extent of the disease spread to the adjacent structures was assessed in accordance with the International Federation of Gynecology and Obstetrics staging system from 2009. Exclusion criteria were all other stages of this disease: I A and stages higher than II B, as well as the absence of definite histological confirmation of the cervical cancer (primary endometrial or vaginal cancer which infiltrates the uterine cervix). Prior the operation, the following had to be done: the imaging of pelvis and abdomen, chest X-ray in two directions, electrocardiography, internist and anesthesiological examination. The patients' age ranged from 24-79 years (x : 46 years), and the operation duration was 120-300 minutes (x : 210 min.). Stage I B 1 was found in 64.6% of operated patients, 14.8% of the patients were in stage I B 2, 9.1% were in stage II A and 11.4% were in stage II B. Blood loss during the operation ranged from 50-800 ml (on average 300 ml), and the number ofremoved lymph nodes per operation was 14-75 (x : 32). Intraoperative and postoperative complications developed in 6.8% of and 17.7% of patients, respectively. Recurrence was reported in 22(12.5%) patients, most often in paraaortic lymph nodes (3.4%) and parametria (2.8%), while the overall 5-year survival rate was 87% until 2008. Wertheim-Meigs radical hysterectomy is a basic surgical technique for the treatment of initial stages of invasive cervical cancer.