The role of radical parametrectomy in the treatment of XXXX after extrafascial hysterectomy.

@entity1 @entity41 @entity5 @entity2622 @entity3
OBJECTIVES: To assess the morbidity and efficacy of radical parametrectomy (RP) performed following extrafascial hysterectomy in @entity1 with @entity2622 . METHODS: An IRB approved retrospective chart review identified 23 @entity1 that underwent RP with pelvic and/or para-aortic lymphadenectomy and upper vaginectomy. Data were collected on demographics, @entity5 stage, grade, histology, indication for hysterectomy, surgical findings, complications, recurrence, and survival. RESULTS: Of the 23 @entity1 , 2 @entity1 had a stage IA(2) lesion while 21 @entity1 had a stage IB(1) lesion. There were 5 @entity1 with a grade 1 @entity5 , 10 with grade 2, 4 with grade 3, and 4 with unknown grade. Median age was 41 years (range 27-59). The most common indication (48%) for extrafascial hysterectomy was CIS of the cervix. Four @entity1 (17%) had @entity3 to pelvic nodes or evidence of @entity5 at the margin at the time of RP. Three of these 4 @entity1 with a positive specimen received adjuvant radiation and all are alive (mean follow-up 66 months). One @entity1 declined radiation and is alive at 42 months. There were 7 (30%) operative complications: Most notably 4 @entity1 received blood transfusions. Two of 19 @entity1 (11%) with no @entity41 in RP specimen recurred and 1 @entity1 was salvaged with radiation (follow-up 103 months). With a median follow-up of 61 months (range 9-103), overall 5-year survival is 96%. CONCLUSIONS: RP is an acceptable option for @entity1 diagnosed with an @entity2622 at the time of extrafascial hysterectomy. Careful selection of RP for @entity1 unlikely to have @entity41 will obviate the need for radiation in most instances.
