Ewha Med J.  1990 Jun;13(2):101-112. 10.12771/emj.1990.13.2.101.

Study on the Treatment and Prognosis of the Invasive Cervical Carcinoma

• Ahn JJ

• KMID: 1965219
• DOI: http://doi.org/10.12771/emj.1990.13.2.101

Abstract

This study was planned to evaluate the effect the effect of treatment, morbidity and prognosis of 91 cases with invasive cervical carcinoma who were admitted and treated at the Department of Obstetrics and Gynecology, Ewha Womans University Hospital during the period of 4 years from January 1986 to December 1989. The results were as follows : 1) The two-thirds of the cases were found to be in the group of age between 40 and 59, and mean age of the cases was 50.7 year. 2) The majority of the cases(84.6%) were concentrated on the gravida of 5 or more, and also parity with 5 or more were noticed over one-third of cases(36.1%). 3) The most common clinical symptom was vaginal spotting and vaginal bleeding(29.7% respectively), and others were postcoital spotting(13.2%), foul odored leukorrhea(14.3%), lower abdominal pain(14.3%), leukorrhea(11.0%), and back pain(11.0%). 4) Distribution of clinical stage in cases with invasive cervical carcinoma was 24.2% in stage I, 50.5% in stage II, 16.5% in stage III and 8.8% in stage IV. 5) The results of Pap smear were found to be abnormal in the majority of cases(84.6%, III : 27.5%, IV : 17.6%, V : 39.5%), but 15.4% of cases were normal(I:5.5%, II:9.9%). Histological subtypes of the invasive cervical carcinoma were large cell nonkeratinizing type(62.6%), large cell keratinizing type(17.6%), and small cell type(9.9%). Serum CEA levels were measured in 31.9% of cases, and normal level less than 2.5 ng/ml were found to be about one-third of the cases, but the rest had high levels than normal level. 6) Radical hysterectomy with pelvic lymphadenectomy was performed in cases of stage Ia, and IIa(25 cases : 27.5%), radiation in 66 cases(72.5%), adjuvant chemotherapy in 11 cases(12.1%). 7) Accuracy of preoperative stage in operation cases was 56.0%, and 87.5% in stage Ia, 28.6% in stage Ib, and 50.0% in stage IIb. 8) Complications due to cervical carcinoma itself were hydronephrosis, pulmonary congestion, rectovaginal fistula and vesicovaginal fistula. Recurrence rate was 20.0% in operation cases, and 22.2% in radiation cases. 9) The two-year survival rate in confirmed cases(79 cases) by follow up was 100% in stage Ia, 85.7% in stage Ib, 70% in stage IIa by operation, and 100% in stage Ia, 83.3% in stage Ib, 77.8% in stage IIa, 72.2% in stage IIb, 66.7% in stage III, 0% in stage IV by radiation.

MeSH Terms

Chemotherapy, Adjuvant
Estrogens, Conjugated (USP)
Female
Follow-Up Studies
Gynecology
Humans
Hydronephrosis
Hysterectomy
Lymph Node Excision
Metrorrhagia
Obstetrics
Odors
Parity
Prognosis*
Rectovaginal Fistula
Recurrence
Survival Rate
Vesicovaginal Fistula
Estrogens, Conjugated (USP)