Parametrial spread in patients with endometrial carcinoma undergoing radical hysterectomy

The objective of this paper is to study parametrial involvement in patients with endometrial carcinoma undergoing radical hysterectomy. We reviewed in dications for surgery, pathology findings, and outcome of a series of 24 pa tients with endometrial carcinoma who underwent radical hysterectomy. The u terus, cervix and parametrial tissue were processed as step-serial sections . Histologically, 16 patients (67%) had carcinoma involving the cervix. Two o f these patients (8%) had frank histologic parametrial involvement and four (17%) had disease extending to the transitional zone of the cervix. Parame trial involvement was continuous and seen only in patients with involvement of the cervical stroma. Six patients (25%) had pelvic node metastases. Wit h a median follow-up of 53 months (range 2-140), four patients (17%) develo ped recurrences (all within 24 months). Twelve patients (50%), including on e of the two with parametrial invasion, were free of disease for 5 years or longer. We conclude that direct parametrial extension can occur in locally advanced endometrial cancer. Radical hysterectomy with lymphadenectomy can be an ad equate operation for such patients.