Radical hysterectomy versus radiation therapy for stage IB squamous cell cancer of the cervix.
Three hundred forty-five patients with Stage IB squamous cell carcinoma of the cervix were treated at the University of Michigan Medical Center from 1970 to 1985. The overall cumulative 5-year survival rate was 89% and the mean age was 44.6 years. In 213 patients undergoing radical hysterectomy the cumulative 5-year survival rate was 92%; 14 patients were explored for radical hysterectomy that was not performed due to high risk features and their survival rate was 50%. Ninety-seven patients underwent radiation therapy as initial treatment and had a 5-year survival rate of 86%. There was no significant difference when radiation therapy was compared with radical hysterectomy (P = 0.098). The survival rates for lesions 3 cm or smaller were 94% for radical hysterectomy and 88% for radiation therapy. When the lesion was larger than 3 cm, the survival rates were 82% with radical surgery and 73% with radiation therapy. Metastatic disease to lymph nodes was present in 26 of the 213 patients undergoing radical hysterectomy. When 1 to 3 nodes were involved 16 of 19 patients survived and when 4 to 10 nodes were involved 3 of 7 patients survived. The addition of radiation therapy did not influence survival. Complications were similar in both treatment groups. Fistulas occurred in 4 of 213 patients undergoing radical hysterectomy and 1 of 111 undergoing radiation. Second surgery for a complication was required in 6 of 213 patients undergoing radical hysterectomy and 7 of 111 undergoing radiation. Survival and complication rates in early stage squamous cell carcinoma of the cervix are equal with either radical surgery or radiation therapy.
Hopkins
M P
MP
Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor.
Morley
G W
GW
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011832:Radiation Injuries; D012086:Reoperation; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*