title: Analysis of failures in patients with cervical carcinoma treated by radical surgery and external pelvic irradiation.
abstract: In this paper we examine 68 patients who had undergone radical abdominal hysterectomy according to Wertheim-Meigs for Ib-II cervical carcinoma. Post-surgical stage was T1bN0M0 in 35 patients, T1bN1M0 in 3, T2aN0M0 in 7, T2aN1M0 in 6, T2bN0M0 in 13, T2bN1M0 in 4. All the patients, except 5 with ureteral fistulas, had high energy external pelvic irradiation, reaching a dose of 45 Gy. Up to December 1986, the neoplasia had relapsed in 10 patient (14.7%). According to post-surgical stage we observed 1/38 relapses in T1b patients (2.63%), and 9/30 relapses in T2 ones (30%). Otherwise, we observed 3 relapses in the 55 patients with negative lymph-nodes (5.4%), and 7 recurrences in the 13 patients with histologically proven positive lymph-nodes (53.8%). In these last patients 3/7 relapses were distant (42.8%). Nodes status seems to be the most important prognostic factor in patients with IB-II cervical carcinoma. Since lymph-nodal involvement could be indicative of a systemic spreading of disease, we think that an adjuvant polychemotherapy, in addition to surgery and radiotherapy, could improve the prognosis of patients with positive lymph-nodes.
authors.affiliation: Department of Obstetrics and Gynecology, University of Pisa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Fioretti
authors.forename: A
authors.initials: A
authors.lastname: Gadducci
authors.forename: T
authors.initials: T
authors.lastname: Dell'Arciprete
authors.forename: M G
authors.initials: MG
authors.lastname: Fabrini
authors.forename: V
authors.initials: V
authors.lastname: Facchini
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D009367:Neoplasm Staging; D011882:Radiotherapy, High-Energy; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*