Primary surgical treatment of carcinoma stage I of the uterine cervix.

476 cases of Stage I-IV invasive carcinoma of the uterine cervix were treated at the Gynecology Departments in Karlstad and Orebro in 1965-75. 232 (48.7%) were classified Stage I, 198 (85.3%) of them were treated with primary surgery (57 Stage IA and 141 Stage IB). Thirty-four were given primary radiotherapy because of advanced age or co-existing conditions contra-indicating surgery. Of the 141 patients with primary surgery for Stage IB, squamous epithelial carcinoma was established in 88.7% and adenocarcinoma in 11.3%. Surgery revealed lymph node metastases in 13 (9.2%). Postoperative radiotherapy was given to all patients with lymph node metastases, to 3 patients with tumor thrombi in the parametrial vessels, and to 6 in whom surgery had conceivably not been radical. Urinary tract complications requiring reconstructive surgery occurred in 8 (4.0%). The 5-year survival rate with Stage IB was 91.5%, corrected for intercurrent diseases, 5-year survival was 92.8%. Of the 13 with lymph node metastases, 7 were still alive after 5 years. The 5-year survival rate for those without demonstrable lymph node metastases was 94.5%, corrected 96.0%.