Class III vs class II radical hysterectomy in stage IB cervical carcinoma: A comparison of morbidity and survival

The classical Fiver III and a modified class II radical hysterectomy were applied in stage IB patients with cervical cancer and were compared as to morbidity and disease-free survival (DFS). Class III was performed in a group of 68 cases and class II in 50. The mean observation period was 31 and 69 months respectively. Most of the prognostic factors (age, histology, grade, bulky tumors, lymph node (LN) metastases) were comparable in the two groups. Postoperative irradiation was given to 31% and 64% of the type III and II hysterectomy group respecitvely (P<0.05). Perioperative morbidity (mean operative time, blood units transfused, febrile cases and hospital stay) was quite similar. Major complications (mainly voiding problems) were significantly more frequent in class III operation. However, DFS was higher (86.5% vs 76.5%, P < 0.05) after class III hysterectomy. These data indicate that class III operation is a more morbid procedure but appears to be advantageous regarding survival. In order to reduce morbidity without compromising therapeutic results (tailoring the radicality), a better insight in the prognostic factors is necessary.