Carcinoma of the Cervix: A Third Treatment

A selected group of 136 patients with Stage I squamous cell carcinoma of the cervix was treated in six naval hospitals during the period 1957-1965 using a three-stage combined radiation therapy and surgery protocol. Treatment consisted of two radium applications to the cervix, followed in 6 weeks by extraperitoneal lymphadenectomy. If the lymph nodes were tumor-negative, simple hysterectomy in 6 to 6 months completed the protocol. If the nodes were tumor-postive, a course of external pelvic irradiation was given with midline shielding. The incidence of positive nodes was 9.6 per cent. Actuarial survival for all patients was 89.4 per cent, comparabale to the rate obtained by radical surgery or radiation alone. Postoperative and postradiation complications were minimal, with nourinary or bowel fistulas. There was no operative mortality.