Carcinoma of the uterine cervix is the second most common gynecologic malignancy worldwide and the third most common cause of cancer deaths in women all over the world. In 2010, an estimated 12,200 women in the USA were diagnosed with cervical cancer, and 4,210 women died from the disease.

Attempts to treat cervical cancer in the early nineteenth century were deemed largely unsuccessful due to the frequent occurrence of recurrent disease in the vaginal cuff. Surgeons such as Wertheim and Clark postulated that this was likely due to inadequate margin of excision. At the turn of the nineteenth century, these surgeons developed an operation that involved removal of the uterus, along with a wide resection of tissues around the involved cervical tumor.

The primary goal of radical hysterectomy is removal ofthe cervical tumor with a sufficient surgical margin. This entailsremoval of the uterus, cervix, superior vaginal margin, andparametrial tissue. Removal of the latter involves extensive dissectionof the bladder, ureters, rectum, and lateral pelvic sidewalls.

Cervical cancer is staged clinically. All stages may betreated with a combination of radiotherapy and chemotherapy;however, early-stage cervical cancer may be treated witha radical hysterectomy. While microinvasive disease orstage IA1 can be adequately treated with a vaginal or simpleabdominal hysterectomy, radical hysterectomy along withpelvic lymphadenectomy is utilized to treat stages IA2 throughIIA. The overall survival of early-stage cervical cancer is similarbetween radical hysterectomy and radiotherapy. Therefore,patients who are poor surgical candidates due to severemedical illness or morbid obesity are probably best treatedwith primary radiotherapy.