title: Carcinoma of the cervix: an analysis of prognostic factors, treatment and patterns of failure following Wertheims hysterectomy.
abstract: A clinicopathologic analysis of 70 patients treated by radiotherapy and/or chemotherapy following primary radical surgery has been undertaken. Clinical stage at presentation was IB (58 patients) and IIA (12 patients). Thirty-five patients (50%) had squamous carcinoma, 23 (33%) had adenosquamous carcinoma, 9 (13%) had adenocarcinoma and 3 (4%) had an undifferentiated neoplasm. The reasons for further treatment were: (i) pelvic lymph node metastases (PLNM), 35 (50%); (ii) inadequate central clearance (ICC), 13 (18%); (iii) recurrent disease (RD), 17 (24%); (iv) others, 5 (8%) cases. Sixty-seven patients had radiotherapy, one of whom also received adjuvant chemotherapy, three patients had chemotherapy alone, and 12 patients received chemotherapy for recurrence following radiotherapy. The 5-year survival in the above referral groups were: (i) 66%; (ii) 62%; (iii) 12%. The site of relapse following treatment was primarily pelvic in groups 2 (ICC) and 3 (RD) and extrapelvic in group 1 (PLNM). Of the histologic parameters studied the only factor of statistical significance in predicting outcome in this group who are recognized to have a generally poor prognosis was the presence of parametrial extension (P = 0.0066). Six cases (9%) developed complications following therapy, lymphoedema being the most common (66%).
authors.affiliation: Department of Radiotherapy and Oncology, Christie Hospital, Manchester; Departments of Reproductive Pathology and Obstetrics and Gynaecology, St Mary's Hospital, Manchester; Department of Obstetrics and Gynaecology, Royal Victoria Hospital, Blackpool, UK.
authors.forename: J P
authors.initials: JP
authors.lastname: Logue
authors.forename: R J
authors.initials: RJ
authors.lastname: Hale
authors.forename: F L
authors.initials: FL
authors.lastname: Wilcox
authors.forename: R D
authors.initials: RD
authors.lastname: Hunter
authors.forename: C H
authors.initials: CH
authors.lastname: Buckley
authors.forename: V R
authors.initials: VR
authors.lastname: Tindall