Since the introduction of the Pap smear and colposcopy, cervical cancers can be diagnosed and treated easily in their preinvasive state. Although theoretically cancer of the cervix should be detected and treated before becoming invasive disease,
there
are still too many women who develop invasive cancer of the cervix and require radical surgery and/or radiation therapy.
During the period from Jan. 1, 1993 through Oct. 31, 1991, 178 women with invasve carcinoma of the uterine cervix were treated by radical hysterectomy land pelvic node dissection at the Department of Obstetrics and Gynecology, Kyung Hee
University
Hospital, Seoul, Korea.
@ES The results were as follows:
@EN 1. The age distribution among the 178 patients ranged from 24 to 75 years, mostly at 50~59 years(34.1%) and 40~49 years(27.7%). The mean age was 46.2 years.
2. The frequent number of pregnancies was 3~8 times (66.6%) and the mean number of pregnancies was 6.1 times.
3. In the distribution by histologic type, squamous cell carcinoma was 89.9%, adenocarcinoma 7.9% and adenosquamous carcinoma was 1.1%.
4. Among the 160 cases of of the invasive squamous cell carcinoma, the histologic subtypes were as follows: large cell nonkeratinizing type was 66.9%, large cell keratinizing type 28.1%, and small cell type was 5.0%.
5. The most frequent clinical symptoms of the invasive carcinoma of the uterine cervix were contact bleeding (37.7%), irregular vaginal bleeding(31.9%), and leukorrhea (10.1%).
6. According to their growth pattern, exophytic growth were 47.1%, endophytic growth 16.0%, eroded and ulcerative growth were 17.4%, and 11.6% respectively.
7. More than half of the invasive carcinoma of the uterine cervix were postmenopausal women(52.2%) and premenopausal patients were 34.0%.
8. Distribution of clinical stage (FIGO) was as follows: stage Ia, 5 cases(2.8%); stage Ib, 94 cases(52.8%); stage Iia, 74 cases(41.6%); stage IIb, 5 cases(2.8%).
9. the most common size of the cervical lesion was 1~3 cm in diameter(44.4%).
10. Among the 178 cases of the invasive carcinoma of the uterine cervix, 41 patients (23.2%) received postoperative adjuvant pelvic radiotherapy.
11. The incidence of lymph node metastasis was 21.6% in stage I and 27.8% in stage II. The overall incidence of regional lymph node metastasis was 24.1%.
12. 19 cases of ovarian transposition were performed in the women who were aged 24~38 years. Among them, 18 cases of right ovary and 1 case of loft ovary were transposed.
13. The frequent coexistent diseases in 178 cases with invasive carcinoma of uterine cervix were myoma uteri(13.1%), anemia(10.2%), adenomyosis (8.7%), hypertenision (8.0%), and diabetes mellitus(7.2%).
14. The mean time for radical surgery was 4.7% hours.
15. The mean blood transfusion in radical surgery was 5.7 pints of blood(whole blood and packed RBC).
16. Mean time for removal of hemovac was 10.7 days after radical hystrectomy in the patients with the invasive carcinoma of the uterine cervix(range 4~31).
17. Duration of hospital stay after radical hystrectomy ranged 9~68 days. The mean was 17.3 days.
18. The result sof survival rate in confirmed patients by follow up at OPD were as follows;
a) The 5-year survival rate was 100% in stage Ia, 88.6% in stage Ib, 86.2% in stage Iia, and 50% in stage IIb. The overall 5-year survival rate was 87.2%.
b) The 5-year survival rate was 75.0% for positive pelvic lymph node metastasis versus 93.2% for negative pelvic lymph node metastasis.
19. Out of total 178 patients, 15 developed recurrence(8.4%). The sites of recurrence were vaginal stump(40.0%), pelvic cavity(36.4%), and distant metastasis(27.2%).
20. Postoperative complications were observed in 67 patients (37.6%) undergoing radical surgery for cervical cancer and 46 patients of them had urologic complications. 15 cases of urinary tract infection, 19 of functional vesical disturbance, 6
of
acute renal failure, 5 of vesicovaginal fistula, 1 of ureteral fistula, 12 of lymphedema of lower limbs, and 5 cases of lymphocyst were found.
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