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Carcinoma of the endometrium with cervical involvement (stage II)
Author(s) -
Tak Won K.
Publication year - 1979
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197906)43:6<2504::aid-cncr2820430650>3.0.co;2-k
Subject(s) - medicine , cervix , radical surgery , radiation therapy , hysterectomy , stage (stratigraphy) , fundus (uterus) , surgery , carcinoma , radical hysterectomy , pathological , cervical cancer , cancer , paleontology , biology
Between September 1968 and December 1976, 88 patients with Stage II endometrial carcinoma underwent treatment at Tufts‐New England Medical Center, Boston. They were subclassified according to microscopic or gross cervical involvement. Five different types of treatment were administered as follows: a) Preoperative external irradiation (4000 rad) and intracavitary radium application (2500 mg hours), followed by total abdominal hysterectomy and bilateral salpingo‐oophorectomy for microscopic involvement when surgery was possible; b) Radical radiotherapy alone for inoperable gross cervical involvement; c) Radical radiotherapy with external irradiation (4000 rad) and intracavitary application (3500 mg hours) for microscopic involvement when surgery was contraindicated due to poor risk of surgery; d) External irradiation (4000 rads) and intracavitary radium (3500 mg hours) followed by simple hysterectomy for gross involvement when surgery was possible; e) Postoperative treatment with external irradiation and vaginal radium for patients referred after hysterectomy. Hysterograms performed in 33 patients showed tumor arising in the fundus and extending to the cervix, and hysterograms performed in 8 patients showed tumor arising in the lower segment of the fundus. Pathologically, once the cervix became involved, there was always some degree of myometrial involvement. The preoperative microscopically involved group and the postoperative group demonstrated similar survival rates, 92% and 90%, respectively, as did the radical radiotherapy group with microscopic involvement and the group with gross cervical involvement, 72% and 70%, respectively, with a follow‐up period of at least one year in all groups. Surgical findings, pathological findings, and results are analyzed in detail by treatment group.