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Carcinoma of the cervix: an analysis of prognostic factors, treatment and patterns of failure following Wertheims hysterectomy
  1. J. P. LOGUE*,
  2. R. J. HALE,
  3. F. L. WILCOX,
  4. R. D. HUNTER*,
  5. C. H. BUCKLEY and
  6. V. R. TINDALL§
  1. *Department of Radiotherapy and Oncology, Christie Hospital, Manchester
  2. Departments of Reproductive Pathology
  3. §Obstetrics and Gynaecology, St Mary's Hospital, Manchester
  4. Department of Obstetrics and Gynaecology, Royal Victoria Hospital, Blackpool, UK
  1. Address for correspondence: Dr J.P. Logue, Clinical Fellow in Radiation Oncology, Ontario Cancer Institute, Princess Margaret Hospital, 500 Sherbourne Street, Toronto, Ontario, Canada, M4X 1K9.


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%).

  • carcinoma
  • cervix
  • radiotherapy
  • Wertheims

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