CLASS-III VS CLASS-II RADICAL HYSTERECTOMY IN STAGE IB CERVICAL-CARCINOMA - A COMPARISON OF MORBIDITY AND SURVIVAL

The classical Fiver III and a modified class II radical hysterectomy w ere applied in stage IB patients with cervical cancer and were compare d as to morbidity and disease-free survival (DFS). Class III was perfo rmed in a group of 68 cases and class II in 50. The mean observation p eriod was 31 and 69 months respectively. Most of the prognostic factor s (age, histology, grade, bulky tumors, lymph node (LN) metastases) we re comparable in the two groups. Postoperative irradiation was given t o 31% and 64% of the type III and II hysterectomy group respecitvely ( P<0.05). Perioperative morbidity (mean operative time, blood units tra nsfused, febrile cases and hospital stay) was quite similar. Major com plications (mainly voiding problems) were significantly more frequent in class III operation. However, DFS was higher (86.5% vs 76.5%, P < 0 .05) after class III hysterectomy. These data indicate that class III operation is a more morbid procedure but appears to be advantageous re garding survival. In order to reduce morbidity without compromising th erapeutic results (tailoring the radicality), a better insight in the prognostic factors is necessary.