COMPLICATIONS AFTER RADIOTHERAPY AND RADICAL HYSTERECTOMY IN EARLY-STAGE CERVICAL-CARCINOMA

Objective. To evaluate the overall complications, major as well as min or, in patients treated for early-stage cervical carcinoma as related to treatment parameters. Methods. In this retrospective study, 167 con secutive patients with early-stage cervical carcinoma treated with pre operative radiotherapy and radical hysterectomy were investigated. Cli nical data were collected from the medical files.Results. Transient or permanent complications appeared in up to half of all patients. Seven percent exhibited intraoperative complications and 35% suffered from early postoperative urinary tract problems; most frequently urinary tr act infection. After one year, the urinary tract complications dominat ed; voidance difficulties and incontinence being most common. Gastroin testinal complications occurred in 15% of patients. Lymphedema appeare d during the first year in 21% of the patients but several of the mild or moderate cases improved after the first year. The relative risk of lymphedema was increased with shorter duration of surgery, extensive preoperative irradiation to the bladder and after external postoperati ve irradiation. Some form of late sequelae remained in every fifth pat ient, and every fourth patient, aged 24-44 years, periodically suffere d from vasomotor symptoms despite estrogen replacement therapy. Conclu sion. The complications after radiotherapy and radical hysterectomy in early stage cervical carcinoma suggest that attempts should be made t o evaluate effective treatments designed to minimize risk to patients.