Tumor recurrence and survival in stage IB cancer of the cervix

Clinical records of 371 women with carcinoma of the cervix, Stage IB, treated in the decade 1969-1979 were reviewed. Cancer recurred in 67 women (18.1%). A group of 171 patients treated by radiation, including 25 who were surgically staged prior to treatment, was compared to 200 patients treated by radical abdominal hysterectomy and pelvic node dissection, including 35 who had postoperative whole pelvis radiation. A multifactorial analysis included time to recurrence, site of recurrence, treatment for recurrence, and survival after recurrence. Pathology review and clinicopathological correlation included tumor configuration, histologic type, size of tumor in greatest dimension, and rate of node metastases in patients undergoing either radical hysterectomy or surgical staging procedures. Lesion size was found to be the most accurate predictor of disease-free survival; this was true whether the patient was treated by surgery or radiation and was not significantly affected by the tumor histology. Nodal metastases were associated with increasing size of lesions and predicted high recurrence rates. Node metastasis rates were not affected by the histology of the tumor.