Adenocarcinoma of the cervix and of the cervical stump

Abstract

1.1. The incidence of adenocarcinoma of the cervix or of the cervical stump was 3.4 per cent in a series of 1,441 patients with carcinomas of the cervices or of the cervical stumps who were registered in the ten years, 1938 to 1947.2.2. Forty-two of the adenocarcinomas, when first seen, were Stage II, III, or IV. Histologic grading was, in all probability, inaccurate but the incidence of undifferentiated carcinomas was high.3.3. The average duration of symptoms before the patients were seen was nine months; the average delay in diagnosis and the starting of treatment was ten months.4.4. There were eleven (22 per cent) patients in this series of 50 who had adenocarcinomas of the cervical stumps. This incidence, with our high incidence of squamous-celled carcinomas in cervical stumps, strengthens our conviction that panhysterectomies are preferable to supravaginal hysterectomies.5.5. “Adequate” x-ray and radium therapy, as the only method of treatment, was given 18 patients. Two (11.1 per cent) are living; one has lived 36 months and one 96 months with no evidence of disease. The other 16 patients are either in the terminal stages of the disease, are dead, or are lost and counted as dead of cancer.6.6. Five patients had radical hysterectomies or radical removals of the cervical stumps and radical pelvic lymphadenectomies. Cancer was found in the cervices of four patients, in the uterus and vagina in one, and in the pelvic lymph nodes in four. All of these patients died of cancer.7.7. Seven patients had radical hysterectomies and radical pelvic lymphadenectomies. In one the left iliac nodes showed cancer; in the other six there were no positive nodes. This patient with positive nodes has lived 60 months and two other patients have lived 64 and 72 months, respectively, without evidence of cancer. The four other patients have lived 24, 8, 8, and 7 months, respectively, without evidence of cancer.8.8. There were no deaths in this series from either irradiation therapy or from operations.9.9. Of the thirteen (26 per cent) patients living at present without evidence of disease, only six (12 per cent) have reached or passed the five-year limit at which we list the patients as “presumptive” cures.