Surgery following chemotherapy and radiotherapy for advanced carcinoma of the cervix

Ten patients with advanced squamous carcinoma of the cervix have been treated with both radiotherapy and monthly cyclical chemotherapy. All patients have subsequently undergone a simple hysterectomy and bilateral salpingo-oophorectomy with para-aortic and pelvic node biopsy. Six patients were found to be histologically free of disease, 2 patients had residual cervical disease completely excised, and 2 patients had persistent intra-abdominal disease. Eight patients have survived 24-43 months one of whom has recurrent disease. The addition of chemotherapy to standard radiotherapy appears to have improved the results of treatment, however, in view of the high complication rate (50%) it is considered that surgical assessment of response is not justified and that surgery should only be undertaken where there is good evidence of persistent but operable disease.