Carcinoma of the cervical stump: Comparison of radiation therapy factors, survival and patterns of failure with carcinoma of the intact uterus

Abstract

Eighty-nine patients with previously untreated invasive carcinoma of the cervical stump were seen at Yale-New Haven Hospital from 1953 through 1977. This represented 9.4% of the carcinomas of the cervix seen during this time period. Eighty-five of the 89 patients (95.5%) had “true” cancers of the cervical stump diagnosed 2 years or more after subtotal hysterectomy, while 4 of the 89 patients (4.5%) had “coincident” cancers diagnosed within 2 years of the subtotal hysterectomy. All cervical cancers were staged by the F.I.G.O. classification. Patient characteristics, methods of management, failure sites and survival of patients with carcinoma of the cervical stump were compared to those patients with carcinoma in the intact uterus. Patients with cervical stump cancers were treated in a similar manner to those with carcinomas of the intact uterus, using a combination of external beam irradiation and intracavitary radium. The stump cancer patients had a similar stage distribution to the patients with cancers of the intact uterus but, on the avenge, they were older and received less irradiation. The patterns of failure were similar on a stage for stage basis, but the survival and disease-free survival for stump cancer patients were superior to those of the patients with carcinoma of the intact uterus. The 5-year disease-free survival rates according to stage for the patients with carcinoma of the cervical stump were: 83.8% for Stage I, 77.6% for Stage II, 51.0% for Stage III, and 37.1% for Stage IV; compared with 84.2%, 60.9%, 30.1% and 18.3% for the intact uterus in the same stages.