Surgical and combination therapy of cancer of the cervix uteri stages Ib and IIa

From 1974 to 1977, 211 consecutive women with carcinoma of the cervix stage Ib and IIa were referred to the Departments of Gynecology and Radiotherapy of the University Hospital, Odense. In 111 women the treatment was combination therapy, i.e., radium after the Stockholm-method (2100 rad two times with a 3-week interval) and extended hysterectomy with lymph node exeresis 6 weeks after the first application of radium. In 30 women treatment was exclusively with surgery, when age, weight, psyche, and tumor extension indicated. The third group of 70 women were treated with full radiation therapy because of advanced age, psychological reasons, or when medical disease contraindicated operation. Concerning survival all the women treated exclusively with surgery are still alive, and until now there seem to be no differences between the two other groups. If surgical and combined therapy were sufficient the urological and intestinal complications were few. The risk of central recurrence was eliminated, and normal sexual function could be preserved. It is recommended that treatment of cancer of the cervix be centralized. Specialized teams of gynecologists and radiotherapists are imperative if a high survival and quality of life is to be secured in women with early cervix cancer.