ABSTRACT
The basis of treatment is the total hysterectomy and bilateral salpingooophorectomy also taking a cuff of upper vagina (see Chapter 3), though there is a recent trend towards more extensive operations taking the pelvic lymph nodes as well. This is supplemented by radiotherapy before and/or after the surgery. Pre-operative radiotherapy can increase the difficulty of the operation but may reduce the risk of spreading the disease by the operative manipulations. If pre-operative treatment is given, the surgery is best planned for about six weeks after the radiotherapy when the early reactive oedema has resolved but mature fibrous tissue has not yet developed.
