Volterrani F, Feltre L, Di Giuseppe M, Böhm S, Fontanelli R, Di Re F, Luciani L
Radiol Med. 1983 Jan-Feb;69(1-2):21-8.
In the years 1971-76 we have treated 243 stage Ib cancers of the cervix. 104 (45.9%) were submitted to a radical surgery in the form of a classical Wertheim-Meigs operation in 32 of them, whilst in the other 72 lymphadenectomy was extended to the lumbar-aortic chains. When feasible, all the operated cases were submitted to a postoperative radiumtherapy on the vaginal vault and to external irradiation if N+ at histological examination. 114 cases (46.9%) were submitted to a complete course of radiotherapy. The remaining 25 cases (10.3%) were submitted to a preoperative radiumtherapy plus radical surgery. The 5-year NED survival was 89.5% in the surgical group, 93.0% in the radiotherapy group and 91.1% for the patients submitted to a preoperative radiumtherapy. In the time interval considered the stage II cases were 89. 14 (15.7%) were operated upon, 66 (74.2%) were treated with a complete course of radiotherapy and 9 (10.1%) were submitted to a preoperative radiumtherapy plus radical surgery. The 5-year NED survival was respectively 83.8%, 67.1% (only for proximal-stage II cases) and 100.0%. Radiotherapy is equivalent to surgery for the treatment of the stage Ib cervical cancers. On the contrary several arguments claim a combined therapeutic approach in the treatment of the stage II cases.
在1971年至1976年间，我们治疗了243例Ib期宫颈癌。其中104例（45.9%）接受了根治性手术，32例采用经典的韦特海姆-梅格斯手术，另外72例的淋巴结清扫术扩展至腰主动脉链。可行时，所有手术病例术后均接受阴道穹窿镭疗，若组织学检查为N+则接受外照射。114例（46.9%）接受了完整疗程的放疗。其余25例（10.3%）接受了术前镭疗加根治性手术。手术组的5年无病生存率为89.5%，放疗组为93.0%，接受术前镭疗的患者为91.1%。在所考虑的时间段内，II期病例有89例。14例（15.7%）接受了手术，66例（74.2%）接受了完整疗程的放疗，9例（10.1%）接受了术前镭疗加根治性手术。5年无病生存率分别为83.8%、67.1%（仅适用于近端II期病例）和100.0%。对于Ib期宫颈癌的治疗，放疗与手术等效。相反，有几个论据支持在II期病例的治疗中采用联合治疗方法。
