Abstract
Objective: The aim of this study was to compare radical hysterectomy to extrafascial hysterectomy in the primary treatment of stage II carcinoma of the endometrium. Methods: We performed a retrospective review of women who underwent primary surgical therapy for stage II endometrial cancer at a single institution over a 15-year period. Results: Forty-seven women underwent radical (n = 16) or extrafascial (n = 31) hysterectomy and surgical staging at H. Lee Moffitt Cancer Center (Tampa, FL) from 1988 to 2003 for stage II endometrial carcinoma. There was no significant difference between the two groups for median age, body mass index (BMI), medical comorbities, length of hospitalization, return to regular diet, operative complications, or postoperative complications. The radical hysterectomy group demonstrated longer operative times by 30 minutes (p = 0.04), increased blood loss by 150 cc (p = 0.03), and longer duration of indwelling catheters (1 versus 17 days; p < 0.01). Prognostic tumor characteristics were similar between the groups, with the exception of more high-grade histology in the radical hysterectomy group (p < 0.01). Adjuvant radiotherapy was given to 3 of the women (19%) in the radical hysterectomy group and to 22 of the women (71%) in the extrafascial group (p < 0.01). There was 1 (6%) and 6 (19%) patients who developed recurrent disease in the radical hysterectomy and in the extrafascial group patients, respectively (p = 0.22). The mean follow-up was 41 months (range, 1–170 months) from the day of surgery, and there was no difference in overall survival. Conclusions: No difference in perioperative complications were observed between the groups. Radical hysterectomy was associated with decreased adjuvant radiotherapy administration and increased operative time, blood loss, and prolonged catheterization. No difference in oncologic outcome was observed. (J GYNECOL SURG 21:111)
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