Radical hysterectomy and pelvic lymphadenectomy for XXXX of the cervix: 21 years experience.

@entity1 @entity146 @entity5 @entity190 @entity957 @entity189 @entity420
From September 1971 through December 1982, 153 @entity1 with @entity5 of the cervix underwent radical hysterectomy and pelvic lymphadenectomy at two of the teaching hospitals of the Uniformed Services University of the Health Sciences. Records were retrospectively analyzed and independent pathologic review was performed. All surgical procedures were performed by fellows or senior residents under the direct supervision of the gynecologic oncology staff of the Walter Reed Army Medical Center or the Naval Hospital, Bethesda, Maryland. In this series, IB @entity189 was defined as @entity957 clinically confined to the cervix with invasion greater than 5 mm from the basement membrane or any @entity420 confined to the cervix. The average age of the @entity1 was 38.3 years. The histologic types were squamous in 72%, @entity420 in 16%, and adenosquamous in 10.5%. The mean operating time was 5 hr and 40 min with an average @entity190 of 1800 cc. There were two ureterovaginal and two vesicovaginal fistulae for an overall fistula rate of 2.6%. Actuarial survival for these 153 @entity1 is 84%. This extends the previous series of R. C. Park, W. E. Patow, R. E. Rogers, and E. A. Zimmerman, Obstet. Gynecol. 41, 117-122 (1973) of 122 cases collected from 1961 to September 1971 to 275 cases. In comparing the two time periods, no significant differences were found in operative technique or complications, but there was a change in the incidence of @entity420 and mixed cell types and a difference in survival. A relatively higher incidence of @entity146 may indicate the need for different therapeutic approaches in the future.
