[Comparison of radiotherapy and surgery in the management of cervical cancer in stages Ib and II].

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.