title: The impact of aborted radical hysterectomy in patients with cervical carcinoma.
abstract: OBJECTIVE
  To determine the impact of an aborted radical hysterectomy on morbidity and overall survival in patients undergoing surgical treatment for early stage cervical carcinoma.
  
  
  METHODS
  Following IRB approval, a computerized database identified 304 women treated with radical surgery for early stage cervical carcinoma from 1994 to 2000 of which 23 (8%) had an aborted radical hysterectomy.
  
  
  RESULTS
  Of the 23 patients, 17 patients had a IB(1) lesion, 4 patients had a IB(2) lesion, and 2 patients had a IIA lesion. Median age was 42 years (range 28-60). Twenty-one patients had squamous cell carcinoma and two patients had adenocarcinoma. Radical hysterectomy was aborted for the following reasons: 11 patients had pelvic extension, seven had positive pelvic nodes, and five patients had positive paraaortic nodes. All 23 patients received postoperative radiation therapy; additionally, 12 patients received concurrent chemotherapy consisting of platinum with or without 5-FU. There were four operative complications (17%) including deep vein thrombosis, wound infection, blood transfusion, and an ileus. Four patients (17%) had radiation-associated complications. Six of 23 (26%) patients experienced a recurrence. The 5-year overall survival was 83% with a median follow-up of 59 months (range 12-107 months).
  
  
  CONCLUSIONS
  A small percentage of patients (8%) with early stage cervical carcinoma will have an aborted radical hysterectomy for pelvic extension or positive nodes. Fortunately, these patients still have a favorable prognosis with postoperative radiation therapy. Aborted radical surgery does not significantly increase overall complications.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecology Oncology, University of Alabama at Birmingham, Birmingham, AL 35249-7333, USA. Trey_Leath@yahoo.com
authors.forename: Charles A
authors.initials: CA
authors.lastname: Leath
authors.forename: J Michael
authors.initials: JM
authors.lastname: Straughn
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Estes
authors.forename: Tyler O
authors.initials: TO
authors.lastname: Kirby
authors.forename: Snehal M
authors.initials: SM
authors.lastname: Bhoola
authors.forename: Mack N
authors.initials: MN
authors.lastname: Barnes
authors.forename: Larry C
authors.initials: LC
authors.lastname: Kilgore
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Alvarez
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009017:Morbidity; D009367:Neoplasm Staging; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*