Radiation management of carcinoma of the cervical stump

In spite of a low incidence of carcinoma of the cervical stump at the present time, the management of this interesting disease deserves special attention because of the success which can be obtained with proper treatment. We have reviewed our cervical stump cases treated at the University of Maryland Hospital, Department of Radiation Therapy, from 1962 to 1973. Of 107 cases treated, only 100 cases were "true cases" of carcinoma of the stump and were eligible for this study. 7 cases were excluded from the study because they were probably coincidental carcinomas and were treated soon after subtotal hysterectomy. The lesions were staged according to the FIGO system. 93 cases (93%) were invasive squamous cell carcinoma, 6 cases (6%) adenocarcinoma and 1 case (1%) transitional cell carcinoma. Of 100 cases with a minimum 5 year follow-up, the absolute 5-year cure rate for various clinical stages is as follows: Stage I 83.3% (20/24); Stage IIA 75.0% (9/12); Stage IIB 62.5% (20/32); Stage IIIA 50% (1/2); Stage IIIB 48% (12/25); Stage IV 20% (1/5). The overall absolute 5-year cure rate for all stages combined is 63% (63/100) compatible with a series reported by M.D. Anderson. A better result in Stage IIIB as compared to several previous reports is thought to be due to extensive and aggressive interstitial radium therapy properly combined with external supervoltage irradiation. Techniques of treatment stage by stage including computerized dosimetry will be discussed along with complications and failures.