The bulky 6-cm barrel-shaped lesion of the cervix: primary surgery and postoperative chemoradiation.
OBJECTIVE
The purpose of this report is to detail what appears to be the largest reported experience of primary radical hysterectomy for bulky barrel-shaped cervical cancers of 6 cm or greater in diameter, followed in all instances by radiation therapy and chemotherapy.


METHODS
Twenty-two unselected cases were operated primarily. One had unresectable aortic node disease. Twenty-one were treated with intent to cure. All patients received extended field radiation therapy beginning 4 weeks after surgery. All patients also received infusion chemotherapy during weeks 1, 4, and 7 of their radiation therapy. Initially, 5-FU was the drug of choice; more recently, Platinol has been employed.


RESULTS
The Berkson-Gage relative survival of the total 22 cases was 71.3%. For the 21 cases treated with intent to cure, the survival was 75.4%. Complications were minimal.


CONCLUSIONS
The experienced pelvic surgeon can accomplish this exercise with a high degree of safety; and this multimodality approach is offered as another therapeutic alternative for these high-risk patients.
Boronow
R C
RC
University of Mississippi Medical Center, Jackson, Mississippi 39202, USA.
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery / Q000628:therapy; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007044:Hysterectomy; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery / Q000628:therapy*
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil