29 Adjuvant chemotherapy after radical hysterectomy for cervical cancer

Abstract

Invasive cervical cancer can be treated by surgery, radiotherapy, and cytostatic chemotherapy. For decades, surgery alone or in combination with radiotherapy was the treatment of choice. At our hospital, primary radiotherapy was reserved for patients with advanced disease. Antineoplastic agents, especially combinations which included cisplatin, achieved good results in patients with advanced disease--or after other therapeutic modalities had been exhausted. This led us to use postoperative chemotherapy for high-risk patients with positive pelvic or parametrial nodes or vascular invasion. Radiotherapy had not improved the survival of such patients. A combination of bleomycin, vincristine, mitomycin C and cisplatin was used. The results were compared with those of patients who had received radical abdominal surgery only (n = 166) or surgery and postoperative radiotherapy (n = 170). The 29 patients who underwent surgery and chemotherapy had a statistically higher incidence of all risk factors. Nonetheless, after a three-year follow-up they had fewer recurrences and fewer deaths than did the other patients. We believe that systemic antineoplastic treatment can reduce recurrences and death in patients with invasive systemic cervical cancer.