A modified radical hysterectomy (class II) did not improve locoregional control and survival compared with simple extrafascial abdominal hysterectomy (class I). Investigators from University of Milano-Bicocca in Monza, Italy, randomized 520 patients with stage I endometrial cancer to class I or class II surgery. They found that the median length of parametria and vagina removed were 15 mm and 5 mm respectively for class I hysterectomy vs 20 mm and 15 mm for class II hysterectomy (P > .001). Operating time and blood loss were statistically significantly higher for class II hysterectomy. Five-year disease-free survival and overall survival was 87.7% and 88.9% respectively in the class I arm, and 89.7% and 92.2% in the class II arm (Ann Surg Oncol online, October 16, 2009).