[Significance of total hysterectomy in uterine cervical cancer persistent in the uterine cervix after radiotherapy].
Radiation therapy is an important means for treating advanced cases of cervical cancer. There are cases, however, in which cancer cells persist even after treatment has been completed. We in the Department of Gynecology at the Cancer Institute Hospital actively performed total hysterectomies in such patients with no distant metastases and no extension of the parametrial induration to the pelvic wall, and obtained favorable results. In the present study, the clinical stage, histological type, degree of removal of involved tissue, and relationship between the prognosis and the maximum diameter of the tumor in the extirpated uterus were examined in 28 patients with advanced cervical cancer treated during the thirty-year period from 1957 to 1986. The following results were obtained: 1. The clinical stage and histological type of the cancer prior to radiation therapy did not significantly affect the prognosis after total hysterectomy. 2. The 3-year survival rate for the patients in whom all involved tissue could be removed was 81.0 percent. In contrast, all those in whom complete removal was impossible survived less than 3 years, despite additional therapy. 3. Prognosis was better in the patients who had tumors with a maximum diameter of less than 2 cm than in those who had tumors with a maximum diameter of 2 cm or more (p less than 0.05). 4. Patients in whom all involved tissue could be removed and in whom the maximum diameter of the tumor was less than 2 cm had a good prognoses, with 88.9 percent surviving at least 3 years after surgery.
Nakayama
K
K
Department of Gynecology, Cancer Institute Hospital, Tokyo.
Hamada
T
T
Yamauchi
K
K
Fujimoto
I
I
Hasumi
K
K
Masubuchi
K
K
D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*