'follow up' Management of Ca Cervix Primary Management of Note - Radiotherapy can also be used for stages la to Ila if patient is medically inooperable. Trachelectomy or cervicectomy refers to surgical removal of cervix. In radical trachelectomy parametria and vaginal cuff are also excised along with removal of cervix. This is a feility preserving alternative to radical hysterectomy in younger patients with early stage carcinoma. Types of hysterectomy Type I - Simple (extrafascial) hysterectomy routinely done for benign conditions for e.g. fibroid. Type II - (Weheim's or modified radical hysterectomy) In type II along with hysterectomy, medial half of the cardinal and uterosacral ligaments and proximal 1-2 cm of vagina are also removed. Type III - (Meigs radical hysterectomy) It includes removal of most of the uterosacral and cardinal ligaments and the upper one third of the vagina. Both type II & type III hysterectomy includes pelvic lymph node dissection. Type IV - (extended radical hysterectomy) In type IV, the periureteral tissue, superior vesical aery, and as much as 3/4th of vagina in addition are removed. Type V (paial exenteration) - Poions of the distal ureter and bladder are resected. Type IV & V are rarely performed because radiotherapy is more adequate treatment in extensive disease. These factors are seen during histopathological examination of specimens (uterus, cervix, parametria, vaginal cuff, lymph nodes etc.) of radical hysterectomy and lymphadenectomy. Let's also have a revision of Ca Cx staging FIGO Staging of Carcinoma of the Cervix Preinvasive Carcinoma 0 Carcinoma in situ Invasive Carcinoma I Carcinoma is strictly confined to the cervix lA Invasive cancer identified only microscopically. All gross lesions even with superficial invasion are stage lB cancers. Invasion is limited to measured stromal invasion = 5 mm deep and < 7 mm wide. IA1 Measured invasion of stroma">