title: The role of vaginal hysterectomy in the treatment of endometrial carcinoma.
abstract: Between 1964 and 1991, vaginal hysterectomy was performed in 60 patients with clinical stage I endometrial carcinoma, who were not considered candidates for the conventional surgical approach. Of these patients, 66.7% were obese with a median weight of 235 pounds. Other risk factors included hypertension (63%), diabetes mellitus (34%), cardiac disease (28%) and pulmonary disease (12%). Operative mortality was 0%. The complication rate was 14%, with four patients requiring transfusions and four patients developing vaginal cuff cellulitis. Forty per cent of patients received adjuvant pre- or postoperative radiation therapy. Crude survival at 5 and 10 years was 91.1% and 87.1%, respectively. However, only one patient died from disease 6 years after primary treatment. Although we consider surgical staging as the standard of care for the treatment of endometrial cancer, vaginal hysterectomy has a definite place in the management of patients with good prognostic criteria who are at high operative risk for the standard surgical approach.
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor, Michigan and Puget Sound Oncology Consortium, Seattle, Washington, USA.
authors.forename: R.J.
authors.initials: RJ
authors.lastname: Lellé
authors.forename: G.W.
authors.initials: GW
authors.lastname: Morley
authors.forename: W.A.
authors.initials: WA
authors.lastname: Peters