Brachytherapy and vaginal hysterectomy for low-stage uterine cervix carcinoma

Objective. The aim of this study was to assess safety and efficiency of a l imited vaginal hysterectomy after brachytherapy in patients with early uter ine cervix carcinoma without unfavorable prognostic factors. All tumors wer e less than 1.5 cm in diameter. Material and methods. Between October 1992 and December 1995, 22 patients w ith low-stage uterine cervix carcinoma (stage Ia2 with vascular invasion, 3 cases; stage Ib1, 19 cases) were included in this study. Patients underwen t the following procedures: single utero-vaginal brachytherapy after a prev ious negative laparoscopic lymphadenectomy (median number of lymph nodes: 1 2) followed 6 weeks later by a limited vaginal hysterectomy. Results. Two mild intraoperative complications were noted. Venous hemorrhag e (100 cc) occurred in one patient during lymphadenectomy and another patie nt experienced bladder injury during hysterectomy. These two complications were successfuly controlled with no need for laparotomy. Only one late comp lication was observed and was evaluated as a bladder grade G2(b) according to the Franco-Italian glossary. With a 30 (22-50) month follow-up, no recur rence was reported. Conclusion. These results appear promising in patients with very early cerv ix carcinoma but remain to be confirmed on a larger scale. (C) 1998 Academi c Press.