Radical hysterectomy for invasive cervical cancer: A 25‐year prospective experience with the Miami technique

• Published in: Cancer Vol. 71; no. S4; pp. 1422 - 1436
• Main Authors: Averette, Hervy E., Nguyen, Hoa N., Donato, Daniel M., Penalver, Manuel A., Sevin, Bernd‐Uwe, Estape, Ricardo, Little, William A.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 15.02.1993; Wiley-Liss
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - secondary; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - surgery; cervical carcinoma; Female; fistula; Humans; Hysterectomy - adverse effects; Hysterectomy - methods; Hysterectomy - mortality; Lymph Node Excision; Lymphatic Metastasis; Medical sciences; Middle Aged; morbidity; mortality; Neoplasm Staging; Parity; Pelvis; Prospective Studies; radical hysterectomy; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; survival; Survival Rate; Uterine Cervical Neoplasms - mortality; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery; Uterus - surgery; Vagina - surgery
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.2820710407

Background. The Miami modification of the traditional Wertheim–Meigs radical hysterectomy was used to treat Stage IB–IIA cervical cancer in a 25‐year prospective study involving 978 patients. Methods. The modifications included: vaginal reconstruction and closure using bladder and rectosigmoid serosa, retroperitoneal drainage through abdominal suction catheters, and suspension of the denuded ureters with the ipsilateral obliterated hypogastric artery. Results. The overall corrected 5‐year survival rate was 90.1%, with a surgical mortality rate of 1.4% and an overall urinary fistula rate of 1.4%. This fistula rate was significantly better than a 4.4% incidence rate in a literature survey. Although not measured, the Miami modification appeared to lengthen the vagina. Conclusions. Therefore, it was concluded that radical hysterectomy with the Miami modifications can be done safely in most patients with Stage IB–IIA cervical cancer.