Radical hysterectomy for invasive cervical cancer. A 25-year prospective experience with the Miami technique

Cancer. 1993 Feb 15;71(4 Suppl):1422-37. 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.

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / secondary
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Humans
  • Hysterectomy / adverse effects
  • Hysterectomy / methods*
  • Hysterectomy / mortality
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Staging
  • Parity
  • Pelvis
  • Prospective Studies
  • Survival Rate
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*
  • Uterus / surgery
  • Vagina / surgery