[Criteria for elective irradiation of postoperative patients with stage 1b cervical cancer and radical hysterectomy without pelvic peritonealization].

One hundred and sixty cases of cervical carcinoma have been treated surgically for the last 8 years. The numbers of cases of stage 0, 1a, 1b, 2a, 2b, 3 and 4 were 55, 14, 45, 15, 16, 10 and 1, respectively. Simple or extended hysterectomy without lymphadenectomy was performed for stage 0 and 1a cases, radical hysterectomy for stage 1b, 2a and 2b cases, and staging laparotomy for stage 3 and 4 cases. Before July, 1976, postoperative irradiation had been applied only for stage 1b, 2a, 2b cases with evidence of histological lymph node metastasis. Since two cases of vaginal stump recurrence were encountered during this period, irradiation was performed for all cases with a tumor size greater than 1cm in diameter, or with infiltration reaching half of the cervical wall thereafter. Three year comulative survival rates (3YCSR) for stage 0, 1a, 1b, 2a, 2b, 3a and 3b groups were 100%, 90%, 90.6%, 84.6%, 79.5%, 60% and 55.5%, respectively. In stage 1b group, there was a significant difference (p less than 0.05) in the 3YCSR between the cases with lymph node involvement (65.6%) and without it (96.2%). There was no significant difference in the factors indicating postoperative outcomes (the period for recovery of urinary functions, the incidence of ileus and the fever index) between the cases with and without pelvic peritonealization at the time of radical hysterectomy.