Radical surgery after preoperative intracavitary radiotherapy for Stage IB and IIA carcinoma of the uterine cervix

During the years 1970–1978 one hundred nineteen patients with Stage IB and fifty-eight patients with Stage IIA carcinoma of the cervix were treated by combined preoperative radium and Wertheim hysterectomy with lymphadenectomy at the State University Hospital in Groningen. The overall 5-year survival was 87% for Stage IB and 70% for Stage IIA. The incidence of pelvic lymphnode metastases was 14.8 and 35.4% in Stage IB and IIA, respectively. The presence of lymphnode metastases was significantly related to the presence of residual tumour in the cervix after preoperative radium treatment ( P < 0.01) and was the most significant prognostic factor. The 5-year survival was 37% for those patients with node involvement as compared to 94% for those without lymphatic extension. Complications particularly concerned the urinary tract. The incidence of these complications was greatly reduced as experience grew.