Treatment of 102 patients with
cancer of the cervix by class II and III radical
hysterectomy was reviewed to compare the operative morbidity and efficacy of class II radical
hysterectomy for select cases. Of the 102 patients, 21 had a class II
hysterectomy, whereas 81 patients had a class III
hysterectomy. The class II operation was performed for those subjects in whom invasive
cancer beyond microinvasion could not be excluded after a cone biopsy. The mean age and weight of women having class II and III radical
hysterectomies were nearly identical (41.1 and 40.6 years, respectively, and 66 and 65 kg, respectively). However, the mean
operative time (3.8 and 4.7 hr, respectively; P = 0.001) and postoperative
hospital stay (7.3 and 9.2 days, respectively; P = 0.001) were lower for class II than for class III
hysterectomies. No
fistulas or recurrent
cancer developed following class II
hysterectomy, and no patients had metastatic
cancer in the nodes or parametrium. Among the 81 women undergoing class III
hysterectomy, there were 3 fistulae and 3 recurrences. We conclude that the lesser morbidity, including shorter
operative time and shorter postoperative
hospital stay and excellent
cancer control of the class II radical
hysterectomy and
lymphadenectomy, recommend the operation for selected early
cancers of the cervix especially when a question concerning depth of invasion exists after cone biopsy.