Complications after radiotherapy and radical hysterectomy in early-stage cervical carcinoma


†Department of Obstetrics and Gynecology, University Hospital, S-751 85, Uppsala, Sweden


Objective. To evaluate the overall complications, major as well as minor, in patients treated for early-stage cervical carcinoma as related to treatment parameters.

Methods. In this retrospective study, 167 consecutive patients with early-stage cervical carcinoma treated with preoperative radiotherapy and radical hysterectomy were investigated. Clinical data were collected from the medical files.

Results. Transient or permanent complications appeared in up to half of all patients. Seven percent exhibited intraoperative complications and 35% suffered from early postoperative urinary tract problems; most frequently urinary tract infection. After one year, the urinary tract complications dominated; voidance difficulties and incontinence being most common. Gastrointestinal complications occurred in 15% of patients. Lymphedema appeared during the first year in 21% of the patients but several of the mild or moderate cases improved after the first year. The relative risk of lymphedema was increased with shorter duration of surgery, extensive preoperative irradiation to the bladder and after external postoperative irradiation. Some form of late sequelae remained in every fifth patient, and every fourth patient, aged 24-44 years, periodically suffered from vasomotor symptoms despite estrogen replacement therapy.

Conclusion. The complications after radiotherapy and radical hysterectomy in early stage cervical carcinoma suggest that attempts should be made to evaluate effective treatments designed to minimize risk to the patients.