Stage IIIA carcinoma of the uterine cervix

Carcinoma of the uterine cervix presenting with extension to the lower third of the vagina but without hydronephrosis or fixation to the pelvic sidewall is uncommon. It is classified as stage IIIA by the criteria of the International Federation of Gynecology and Obstetrics (FIGO) and accounts for less than 2% of all cervical cancer cases seen in our institution. Because of the paucity of such cases, the results of treatment of FIGO stage IIIA cervical cancer are generally not reported separately. The radiation therapy treatment program at Yale--New Haven Hospital for stage IIIA patients includes intracavitary and vaginal brachytherapy plus external beam radiation therapy, with a strong emphasis on individualization of treatment. The results of treatment in 17 stage IIIA patients were reviewed. Local--regional tumor control was achieved in 12 of the 17 patients (71%) treated. The actuarial 5-year disease-free survival rate was 58%. Our results suggest that FIGO stage IIIA carcinoma of the cervix has a much better prognosis than FIGO stage IIIB cervical cancer, and we recommend that the results of treatment for FIGO stage IIIA be reported separately.