I operate on uterine cancer together with a team of surgical oncologists. I will review your test results and say which operation is needed, by which approach and what will happen after it.
- Hysterectomythe main operation for uterine cancer
- Laparoscopicthe standard approach for early cancer
- Sentinel nodeslymph node assessment with a lower risk of leg swelling
- Freein-person consultation with review of your test results
Experience and why contact me
Kateryna Valikhnovska, MD
- 13+years of experience
- 9,500hours in the operating room
- 15scientific publications; PhD thesis defended in 2020
Surgical oncologist in Kyiv. Surgeon of the first qualification category, with specialist certificates in Oncosurgery and Transplantology. Member of the Ukrainian Union of Oncology Surgeons (USSO) and the European Society of Surgical Oncology (ESSO). Awarded the Order “Scientist of the Year 2020”.
Laparoscopic hysterectomy
Together with a team of surgical oncologists, I perform laparoscopic hysterectomies with sentinel lymph node biopsy — through several small punctures, without a large incision.
Surgery for advanced cancer
When the tumor has spread beyond the uterus but can be removed completely, we perform extended procedures. The decision on such an operation is made by a tumor board.
Surgery is part of the plan
After surgery, the stage, histology and molecular type of the tumor determine whether additional treatment is needed. We make this decision together with medical oncologists and radiologists.
I explain clearly
What exactly will be removed, whether the ovaries can be preserved, what surgical menopause is — I answer these questions before the operation, not after it.
Direct contact with me
Calls to my mobile number and messages come to me personally, with no call center. If I did not answer, I am in surgery: I will call back within 24 hours.
A year of follow-up after surgery
For a year after the operation I review your test results and images, answer questions and help with decisions about further treatment. It is a separate paid service.
When people say “uterine cancer”, they most often mean cancer of the uterine body — endometrial cancer. Surgery is the main treatment for most patients, provided the tumor has not spread beyond the pelvis and the patient’s condition allows anesthesia. The standard is removal of the uterus together with the fallopian tubes and ovaries, in early cancer usually laparoscopically. I operate together with a team of surgical oncologists. At the consultation I review your test results and explain which operation you need.
At which stage surgery is possible
- Tumor confined to the uterus. Surgery is the main treatment. The extent is standard: the uterus with the cervix, the fallopian tubes and the ovaries.
- Enlarged lymph nodes on MRI or CT, or spread of the tumor to the cervix. The extent of surgery is widened: enlarged nodes are removed, and with cervical involvement the extent is determined individually.
- The tumor has spread beyond the uterus but can be removed completely. The operation is discussed by a tumor board, and treatment after it is determined by the stage and molecular type of the tumor.
- Surgery is contraindicated because of other conditions, or there are distant metastases. If surgery is contraindicated because of other conditions, radiation therapy is considered first. With distant metastases, drug therapy is usually the basis of treatment, and the possibility of surgery is determined by a tumor board.
The diagnosis itself, symptoms and tests are covered on the page “Endometrial (uterine body) cancer”. Cervical cancer is treated differently — see the page “Cervical cancer”.
What is removed during the operation
Uterus, tubes and ovaries
The standard extent is total hysterectomy with removal of the fallopian tubes and ovaries. The uterus is removed together with the cervix, intact, without morcellation.
Sentinel lymph nodes
A dye is injected into the cervix, and the first nodes to which lymph drains from the tumor are removed. This helps to assess lymph node involvement with a lower risk of leg swelling than removal of all pelvic nodes.
Greater omentum
It is removed additionally in certain aggressive tumor types — serous and undifferentiated cancer and carcinosarcoma.
Preserving the ovaries
In premenopausal patients with stage IA grade 1 endometrioid cancer and no involvement of the ovaries or other extrauterine spread, the ovaries can sometimes be preserved — after hereditary risk has been assessed. The decision is made individually.
The uterus itself can be preserved only in selected cases — in young women who plan a pregnancy, with a low-grade (G1) endometrioid tumor that has not invaded the wall of the uterus. Then hormonal treatment is given under strict monitoring, and after childbearing is complete removal of the uterus is recommended.
How the operation is performed
The standard approach for early cancer is laparoscopic, through several small punctures. With a large uterus or an advanced tumor the operation is performed openly. The approach is chosen before the procedure based on the test results and your condition. The duration of the operation depends on its extent.
Hospital stay, recovery and consequences
After surgery, care follows the enhanced recovery (ERAS) protocol: early mobilization, early eating, controlled pain relief. After a laparoscopic hysterectomy the patient is usually discharged within a few days and returns to normal activity in 2–4 weeks.
In premenopausal patients, removal of the ovaries leads to surgical menopause. We discuss how to ease its symptoms before the operation.
After surgery, the risk group is determined by the stage, histology and molecular type of the tumor. At low risk no additional treatment is needed; at higher risk radiation therapy, chemotherapy or a combination is prescribed.
Risks and complications
Risks are what patients ask about least often, although they are the most important thing to discuss before surgery. The main ones are:
- bleeding and infection — as after any operation;
- injury to neighboring organs — the bladder, ureters, bowel;
- thrombosis, including pulmonary embolism — which is why early mobilization after surgery is important;
- leg swelling after removal of lymph nodes — its risk is lower when only sentinel nodes are removed.
The likelihood of each depends on the extent of surgery, body weight, other conditions and previous abdominal operations. I will explain the risks in your particular case at the consultation.
What the cost depends on
The cost of surgery depends on its extent, the approach, the number of days in the hospital and the tests before surgery. The exact amount is named once the treatment plan has been defined. The payment can be split into parts — installments are available. The in-person consultation is free. More details are on the page “Cost of Surgery: What It Depends On”.
Which documents are needed and how to book
- the histology report of the endometrial biopsy and, if available, the results of molecular classification and MMR testing;
- the blocks and slides — for review in another laboratory;
- ultrasound reports, pelvic MRI and CT discs, if they were performed;
- the discharge summary and operative report, if the uterus has already been removed;
- information about other conditions, medicines and cancer in the family.
Book a consultation by phone or through the form. If you are from another city, send the documents in advance — how to do this is described on the page “Online Oncologist Consultation”.
Frequently asked questions
How much does uterine cancer surgery cost?
The cost depends on the extent of surgery, the approach, the number of days in the hospital and the tests. The exact amount is named after the consultation, once the treatment plan has been defined. The in-person consultation is free, and installments are available.
Do the ovaries have to be removed?
Usually yes: the tubes and ovaries are removed together with the uterus. In premenopausal patients with stage IA grade 1 endometrioid cancer and no involvement of the ovaries or other extrauterine spread, the ovaries can sometimes be preserved to avoid early menopause; the decision is made individually, after hereditary risk has been assessed.
Can the operation be done laparoscopically?
For early uterine cancer the laparoscopic approach is standard. With a large uterus or an advanced tumor the operation is performed openly.
What is sentinel lymph node biopsy?
It is the search for and removal of the first lymph nodes to which lymph drains from the tumor, using a dye. The method helps to assess lymph node involvement with a lower risk of leg swelling than removal of all nodes.
How long does recovery take?
After a laparoscopic hysterectomy patients are usually discharged within a few days and return to normal activity in 2–4 weeks. After open surgery recovery takes longer.
Is radiation therapy needed after surgery?
It depends on the risk group: the stage, depth of invasion, histology and molecular type of the tumor. At low risk — no; at higher risk radiation therapy, chemotherapy or a combination is prescribed.
Can the uterus be preserved?
Only in selected cases: a young patient who plans a pregnancy, a low-grade (G1) endometrioid tumor that has not invaded the wall of the uterus. Then hormonal treatment with follow-up biopsies is given, and after childbearing is complete removal of the uterus is recommended.
Surgery is the third of six steps
Surgery is preceded by a review of your documents and a tumor board, and followed by recovery, a decision on further treatment and a year of follow-up.
- Step 1
Review of the clinical situation: all examination materials, CT and MRI discs, medical history.
- Step 2
Discussion of the case by a multidisciplinary team with oncologists, medical oncologists and radiologists.
- Step 3 you are here
Surgery according to international protocols together with a team of surgical oncologists.
- Step 4
The early postoperative period under the ERAS enhanced recovery protocol.
- Step 5
Deciding on further management and support during the chemotherapy stage.
- Step 6
Advisory support for a year: monitoring test results and reviewing CT and MRI discs.
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