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 lymph node metastases was 14.8 and 35.4% in Stage IB and IIA, respectively. The presence of lymph node metastases was significantly related to the presence of residual tumour in the cervix after preoperative radium treatment (P less than 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.