Survival of patients with positive aortic nodes in clinical stage IB and IIA carcinoma of the cervix

Fifty-five patients with histologically confirmed Stage II adenocarcinoma of the corpus uteri were treated with combined radiation therapy and surgery and followed for 2 to 10 years. The overall survival at 5 and 10 years is 75% and 56% respectively; the age adjusted survival is 93%.and 73% respectively. Disease free survival is 88% at 2 years and 83% at both 5 and ID years. Although 10 patients (18%) failed treatment, each local pelvic recurrence was accompanied by dissemination elsewhere. Histological grade and extent of involvement of the uterine cervix at time of examination under anesthesia are statistically significant prognostic factors. Age, depth of uterine sounding, and depth of myometrial invasion by tumor were not of prognostic value. We conclude that combined pre-operative external beam and intracavitary radiation with total abdominal hysterectomy and bilateral salpingo-oophorectomy is the preferred treatment for stage II endometrial carcinoma because of the excellent survival and low morbidity. Furthermore, both histologic grade and extent of cervical involvement predict the natural history of stage II disease.