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  • Title: Radical hysterectomy in the treatment of patients with bulky early stage carcinoma of the cervix uteri.
    Author: Alvarez RD, Gelder MS, Gore H, Soong SJ, Partridge EE.
    Journal: Surg Gynecol Obstet; 1993 Jun; 176(6):539-42. PubMed ID: 8322125.
    Abstract:
    This study was done to assess the role of radical hysterectomy in patients with bulky (greater than or equal to 4 centimeters) early stage carcinoma of the cervix uteri. Of 48 patients with bulky carcinoma of the cervix uteri undergoing Type III radical hysterectomy between 1970 and 1987, 46 patients were Stage 1B and two were Stage 2A. Pathologic estimate of the dimensions of the lesion ranged from 4 x 3 to 9 x 11 centimeters. Fourteen patients had evidence of pelvic node metastasis and one patient had evidence of microscopic metastasis to the para-aortic nodes. Twelve patients received adjunctive radiation therapy for findings of nodal metastasis or tumor near or at the surgical margin. There were recurrences in 19 patients, 13 of which were isolated to the pelvic area. Of the patients with isolated pelvic recurrences, five were salvaged with secondary treatment. The overall five year survival rate was 73.6 percent and the ten year survival rate was 60.6 percent. Radical hysterectomy and lymphadenectomy seems to have equal efficacy and morbidity rates when compared with radiation therapy or the combination of extrafascial hysterectomy and radiation therapy in the treatment of patients with bulky early stage carcinoma of the cervix uteri.
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