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Invasive carcinoma of the uterine cervix: A comprehensive review of twenty years treatment experience at Yale University
Preliminary analysis shows no significant difference between the The actuarial tumor free five-year survival is two treatment groups. approximately 86% for Stage IB and 78% in Stage IIA. In Stage IB there were three pelvic failures in the preoperative group and three in the In Stage IIA the pelvic failures were one in radiation alone group. the preoperative radiation group and two in the radiation alone group. Complications are comparable in both groups (3% major and 5% moderate grade). The pathological analysis of the pelvic lymph nodes removed will be reported. Correlation with survival will be carried out. This study confirms our experience that either modality of therapy is effective in the management of these patients and that the choice of treatment should be individualized depending on the age of the patient, extent of the lesion within a given stage, sexual function and the availability of competent radiation oncologists or gynecological oncologists.
(49) INVASIVE CARCINOMA OF THE UTERINE CERVIX: A COMPREHENSIVE REVIEW OF TWENTY YEARS TREATMENT EXPERIENCE AT YALE UNIVERSITY Daniel S. Kapp, Ph.D., M.D.*, and Enrique Gutierrez, M.D. Department of Therapeutic Radiology Peter Schwartz, M.D.; Ernest I. Kohorn, M. Chir., FRCS, FRCOG, and John McLean Morris, M.D. Department of Gynecology Diana Fischer, Ph.D. Department of Epidemiology Yale University School of Medicine New Haven, Connecticut An extensive retrospective analysis of all patients seen at Yale-New Haven Medical Center for previously untreated invasive carcinoma of the uterine cervix from 1953-1972 has been undertaken. 765 patients studied have been uniformly restaged according to the current F.I.G.O. recommendations. The majority of patients were treated under standardized protocols combining external beam radiation therapy and intracavitary radium therapy delivered by a flexible applicator system (Morris et. al. Radiology 84:849, 1965). Patients have been followed for periods of between 5 and 25 years, and the incidence of persistent disease, complications of treatment and sites of recurrences have been recorded. Pretreatment factors that were found to be of prognostic significance in terms of unadjusted 5-year survival included age, stage, hemoglobin/ hematocrit, and total white blood cell count. Patient parameters that did not appear to influence prognosis (when adjustment was made for stage and age) included race, religion, prior supracervical hysterectomy, prior cone biopsy, gross appearance of lesion (exophytic, endophytic, necrotic) or pyometrium. Factors of possible significance in selective subgroups included histology, BUN, lymphocyte count, weight and uterine depth. The development of second malignancies will also be discussed.
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(49) INVASIVE CARCINOMA OF THE UTERINE CERVIX: A COMPREHENSIVE REVIEW OF TWENTY YEARS TREATMENT EXPERIENCE AT YALE UNIVERSITY Daniel S. Kapp, Ph.D., M.D.*, and Enrique Gutierrez, M.D. Department of Therapeutic Radiology Peter Schwartz, M.D.; Ernest I. Kohorn, M. Chir., FRCS, FRCOG, and John McLean Morris, M.D. Department of Gynecology Diana Fischer, Ph.D. Department of Epidemiology Yale University School of Medicine New Haven, Connecticut An extensive retrospective analysis of all patients seen at Yale-New Haven Medical Center for previously untreated invasive carcinoma of the uterine cervix from 1953-1972 has been undertaken. 765 patients studied have been uniformly restaged according to the current F.I.G.O. recommendations. The majority of patients were treated under standardized protocols combining external beam radiation therapy and intracavitary radium therapy delivered by a flexible applicator system (Morris et. al. Radiology 84:849, 1965). Patients have been followed for periods of between 5 and 25 years, and the incidence of persistent disease, complications of treatment and sites of recurrences have been recorded. Pretreatment factors that were found to be of prognostic significance in terms of unadjusted 5-year survival included age, stage, hemoglobin/ hematocrit, and total white blood cell count. Patient parameters that did not appear to influence prognosis (when adjustment was made for stage and age) included race, religion, prior supracervical hysterectomy, prior cone biopsy, gross appearance of lesion (exophytic, endophytic, necrotic) or pyometrium. Factors of possible significance in selective subgroups included histology, BUN, lymphocyte count, weight and uterine depth. The development of second malignancies will also be discussed.
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