Results of Postoperative Irradiation in Patients with Carcinoma of Uterine Cervix Stage IB and IIA

Ahn, Sung Ja; Nam, Taek Keun; Chung, Woong Ki; Nah, Byung Sik; Choi, Ho Sun; Byun, Ji Soo

Abstract

PURPOSE: The adjuvant postoperative radiotherapy has been usually applied to the patients with unfavorable prognostic factors after radical operation in early cervical cancer. We focused on the evaluation of the survival status and failure patterns of the patients with postoperative radiotherapy.
MATERIALS AND METHODS
We retrospectively analyzed ninety patients with FIGO stage IB and IIA cervix cancer who received postoperative pelvic irradiation at Chonnam University Hospital between August 1985 and December 1988. Seventy-eight patients had adequate follow-up information for survival anlysis. Median follow-up time of these patients was 64 months.
RESULTS
The 5 year overall and disease free survival rate of ninety patients was 80.0% and 80.2% respectively. The prognostic significance to the survival was determined by multivariate analysis. Adequacy of resection margin(p=0.005) and lymph node status(p=0.005) appeared to be independent prognostic factors. Recurrence occurred in 13 Patients, 5 in the pelvis and 8 at distant sites. He median time to recurrence was 19 months(range;3-39 months). The pelvic recurrence was more prevalent in the group of patients with adenocarcinoma, depth of stromal invasion more that 10mm and use of chemotherapy. The distant failure was more prevalent in the group of positive resection margin or positive lymph node with statistical significance.
CONCLUSION
Patients with pelvic lymph node or surgical margin involvement clearly constitute a high risk group in this analysis and should be considered as candidates for some form of adjuvant therapy.