From January 1982 to December 1991 271 patients underwent radical hysterectomy according to the Okabayashi modification for cervical carcinoma stage IB and IIA. Intraoperative complications occurred in 3.3%. The urinary fistula rate was only 2.2%. The 5‐year Disease‐free Interval (DFI) was 90%. In a univariate analysis tumor size 3 cm (n = 99), positive pelvic nodes (n = 53), adenocarcinoma (n = 58) and parametrial involvement (n = 36) were all associated with a significantly decreased DFI. Recurrence occurred in 27 patients (10%) of whom 22 died of disease. In adenocarcinoma, DFI was poor when positive pelvic nodes were present. In squamous cell carcinoma however, DFI was not influenced by pelvic node status. In patients with squamous cell carcinoma the locoregional recurrence rate was 3.4% when pelvic nodes were negative, whereas in those with positive nodes it was 5.8%. These data show that the Okabayashi modification of Wertheim’s radical hysterectomy is a safe procedure resulting in very good locoregional tumor control, especially in patients with squamous cell cancer of the cervix.

The prognosis of early-stage cervical cancer is similar in pregnant and nonpregnant patients when standard treatment is given. Because of the limited number of patients, no conclusions can be drawn about advanced-stage cervical cancer. The goal should be standard oncologic treatment, which does not lead to increased morbidity in pregnant patients.

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Until now, the traditional management of interstitial pregnancy has been surgical. Lately, we have advocated conservative treatment with methotrexate as an option for infertility patients. This is the first publication of a rupture with abundant intra-abdominal bleeding during systemic treatment with methotrexate of a patient with an interstitial pregnancy. Signs of therapy failure are discussed.