Incidence and Predictors of Febrile Morbidity after Radical Hysterectomy and Pelvic Lymphadenectomy for Early Stage Cervical Cancer Patients

Abstract

This study was undertaken to evaluate the incidence and independent predictors for febrile morbidity afterradical hysterectomy and pelvic lymphadenectomy. Patients with FIGO stage IB-IIA cervical cancers who hadundergone RHPL at Chiang Mai University Hospital between January 2003 and December 2005, were reviewed.The clinical variables including the age at diagnosis, menopausal status, body mass index, previous cervicalconization, tumor size, preoperative chemotherapy, preoperative anemia, operative time, and estimated bloodloss were analyzed for prediction of postoperative febrile morbidity. During the study period, 357 women werereviewed. The mean age was 44.7 years. Sixty-five (18.2%) women were postmenopausal. The majority of women(77.3%) were in FIGO stage IB1. The most common histology was squamous cell carcinoma (69.2%). Febrilemorbidity was noted in 94 women (26.3%, 95% CI= 21.8-31.2) in whom 25 (7.0%) had urinary tract infection(19), abdominal wound infection (4), and vaginal cuff infection (2), respectively. Only massive blood loss (>1,500ml) was noted as the significantly independent predictor for febrile morbidity (aOR= 2.7, 95% CI=1.1-6.6,P=0.028). In conclusion, approximately one-fourth of the women undergoing RHPL at our institute hadpostoperative febrile morbidity. Only massive blood loss is a significant predictor for this complication.