DISEASE-FREE INTERVAL AND RECURRENCE PATTERN AFTER THE OKABAYASHI VARIANT OF WERTHEIMS RADICAL HYSTERECTOMY FOR STAGE IB AND IIA CERVICAL-CARCINOMA

From January 1982 to December 1991 271 patients underwent radical hyst erectomy according to the Okabayashi modification for cervical carcino ma stage IB and IIA. Intraoperative complications occurred in 3.3%. Th e urinary fistula rate was only 2.2%. The 5-year Disease-free Interval (DFI) was 90%. In a univariate analysis tumor size greater than or eq ual to 3 cm (n = 99), positive pelvic nodes (n = 53), adenocarcinoma ( n = 58) and parametrial involvement (n = 36) were all associated with a significantly decreased DFI. Recurrence occurred in 27 patients (10% ) of whom 22 died of disease. In adenocarcinoma, DFI was poor when pos itive pelvic nodes were present. In squamous cell carcinoma however, D FI was not influenced by pelvic node status. In patients with squamous cell carcinoma the locoregional recurrence rate was 3.4% when pelvic nodes were negative, whereas in those with positive nodes it was 5.8%. These data show that the Okabayashi modification of Wertheim's radica l hysterectomy is a safe procedure resulting in very good locoregional tumor control, especially in patients with squamous cell cancer of th e cervix.