Lymph node dissection before radical hysterectomy

Hi well i'm a tad confused as the registra said i have to have 2 operations the 1st being the lymph node dissection. She said my lyph nodes were suspect so would have to come out 1st and if they of i would have a radical husrectomy 2 weeks later. Id this normal as i don't understand why the dont just do it all at the same time. I am hving both surgeries done laproscopically.

Hi Chezza,

I had this done in two steps too, it isn't common but it does happen. I'll tell you what happened, but rememer that each case is different. I don't want to scare you so don't panic, my story has a good outcome.

In my case it was because my lymph nodes were enlarged and the MRI wasn't very clear - there was a concern that my tumour might be larger than originally thought. My surgeon wanted to get my lymph nodes checked and to surgically check the area next to my bladder before making a decision about whether to continue with surgery or refer me for radiochemo.

I was treated at a leading teaching hospital and the original plan was to whip out a few lymph nodes and to get them checked by the lab while I was on the table and then make a decision about whether to proceed then and there. In the end they took out more nodes than the lab could process in the time and so they decided to close me up and do the next stage of treatment later.

The lab confirmed that my lymph nodes were completely clear so 4 weeks later I had the hysterectomy. The pathology on all that showed that all of my adenocarcinaoma had actually been removed during the original LLETZ procedure, although it's usual to do the radical hysterectomy for the size and type of tumour I actually had.  The lack of clarity in the MRI was just one of those things, I'm afraid.

If it's any comfort, the second surgery used the same holes as the first so I didn't have any extra scars. It did mean I was out of action for longer and I did find recovering from the lymph node removal quite difficult, but then I did have an exceptionally large number of nodes removed.

My advice is to go back to your consultant or CNS and make sure you understand exactky why they are taking this approach. If they don't give you a solid clinical explanation and say something like 'this is just the way we do it here' then it is ok to ask for a second opinion.

Best of luck x

Reading back your original post I see that you did say that they have some concerns about your lymph nodes. I know it's scary, but I saw the lymph node removal as a further diagnostic test; a way to make sure that I got the treatment I needed. In the end all my nodes were clear so they really can't tell for sure untill they get them under a microscope.

I should also say that I was told that this approach was taken because it's really better to have either radical hysterectomy or radiochemo, rather than both as it's a lot for your body to go through. Also, if you still have your uterus then you can have targetted brachytherapy which isn't possible if it's been removed.  If they do lymph nodes first then they can make sure you are getting the right treatment for your cancer.


Hi Chezza,

This isn't from personal experience, but I have read that if the lymph nodes are positive for cc cells then they will revise the treatment plan, and perhaps do chemo/radiation instead of surgery.