Stage IB or IIA-B carcinoma of the intact uterine cervix greater than or equal to 6 cm in diameter: is adjuvant extrafascial hysterectomy beneficial?

Abstract

This is an analysis of 150 patients with Stage IB or IIA-B carcinoma of the intact uterine cervix greater than or equal to 6 cm in diameter treated with irradiation alone (75 patients) or irradiation followed by surgery (75 patients) at the University of Florida between October 1964 and June 1983. Minimum follow-up in this series was 5 years. There was no significant difference in the distribution of prognostic factors between the two treatment groups. The 5-year local control rate was 74% with irradiation alone and 76% with irradiation and surgery. The 5-year survival rates for irradiation alone versus irradiation plus surgery were as follows: cause specific, 62% and 55%, and absolute, 54% and 52%. The proportion of patients who developed treatment complications necessitating hospitalization or a second operation was 4/75 (5%) after irradiation alone and 12/75 (16%) after irradiation and surgery. The authors conclude that the routine use of adjuvant extrafascial hysterectomy is not warranted in this patient population.