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THE CASE AGAINST WERTHEIM'S HYSTERECTOMY IN ENDOMETRIAL CARCINOMA
Author(s) -
Mûelenaere G. F. G. O.
Publication year - 1973
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1973.tb16059.x
Subject(s) - medicine , endometrial cancer , lymphadenectomy , hysterectomy , pelvis , carcinoma , uterus , obstetrics , lymphatic system , cancer , radiation therapy , incidence (geometry) , gynecology , general surgery , surgery , pathology , physics , optics
Summary One hundred and four women with clinically operable endometrial cancer were treated by intrauterine radium followed by removal of the uterus and appendages without lymphadenectomy. Patients with recurrence confined to the pelvis were given external radiotherapy only. From review of these cases and study of the literature it is concluded that there is a high incidence of lymphatic metastases but these are not usually confined to the pelvis. Most of the deaths from the disease are due to distant lymphatic, transcoelomic or haematogenous spread without pelvic recurrence of the neoplasm. It is difficult to suggest a logical basis for selecting patients with endometrial cancer for Wertheim's hysterectomy with lymphadenectomy, an operation which does not offer a higher 5‐year survival rate in unselected patients. cology and Obstetrics, and Dr. Kenny, Superintendent, H. F. Verwoerd Hospital, for access to their records. The results of the present study formed part of an M.D. thesis for the University of Pretoria in 1972.