POSTOPERATIVE RADIOTHERAPY IN CARCINOMA OF THE CERVIX - TREATMENT RESULTS AND PROGNOSTIC FACTORS

In order to assess the role of postoperative radiotherapy and prognost ic factors, 126 patients who were treated with radiotherapy after surg ery for clinical early-stage carcinoma of the cervix were reviewed. Al l patients received external pelvic radiotherapy and 37 patients were treated with additional vaginal cuff irradiation. The 5-year overall s urvival, disease-free survival and locoregional control rates were 71. 1, 69.9 and 78.1%, respectively. The 5-year disease-free survival rate s were 40% for grade 3 vs. 75.4% for grade 1 tumours (p = 0.05), 76.5% for pathological stage IB versus 54.1% for pathological stage IIA (p = 0.04), 36.6% for node-positive patients versus 82.5% for node-negati ve patients (p = 0.0017), 54% for full thickness cervical invasion ver sus 100% superficial cervical invasion (p = 0.01), 34.8% for positive margins versus 78.1 for negative margins (p < 0.0001). After a multiva riate analysis, tumour grade (p = 0.026) and presence of positive marg ins (p = 0.006) were found to independently influence the outcome. Gra de II and III complication rate was 5.5% in all patients. In conclusio n, postoperative radiotherapy should be used in patients treated with simple hysterectomy as well as those treated with radical hysterectomy with unfavorable pathological findings.