Traitement des cancers limités du col utérin avec hystérectomie simple par voie basse après curiethérapie

SummaryPurpose. ients with early cervix carcinoma, both radiotherapy and surgery or combined modalities provide effective therapies. In the two last modalities, recommended surgery is radical hysterectomy. The purpose of this prospective study was to assess the value of a limited vaginal hysterectomy after brachytherapy in patients without any unfavorable prognostic factor. ts and methods. -two patients (stage Ia2 with vascular invasion: three patients, stage Ib1:19 patients) with 1 cm median maximal tumor size and with previous negative laparoscopic lymphadenectomy (median number of lymph nodes:12) underwent a limited vaginal hysterectomy 6 weeks after utero-vaginal brachytherapy. s. ld intra-operative complications were noted. Veinous hemorrhage (100 mL) occured in one patient during lymphadenectomy and another patient presented bladder injury during hysterectomy. These two complications were successfuly controlled with no need for laparotomy. Only one late complication was observed: bladder grade G2(b). With a 29 months follow-up (20–48 months), no recurrence was reported. sion. results appear promising in patients with very early cervix carcinoma but remain to be confirmed on a larger scale. © 1998, Elsevier, Paris.