[Adjuvant chemotherapy in radical surgery of cervix cancer]

Abstract

Invasive cervical cancer can be treated by surgery, radiotherapy, and cytostatic chemotherapy. For decades, surgery alone or in combination with radiotherapy has been the treatment of choice. Radiotherapy only was reserved for patients with advanced disease. Antineoplastic agents, especially combinations including cisplatin, achieved good results in patients with advanced disease of after other therapeutic modalities had been exhausted. This led us to use postoperative chemotherapy for high-risk patients with positive pelvic or parametrial nodes or vascular invasion. Radiotherapy had not improved the survival of such patients. A combination of bleomycin, vincristine, mitomycin-C and cisplatin and later a combination of carboplatin and bleomycin was used. The results were compared to those of patients with radical abdominal surgery only (N = 118) or with surgery and postoperative radiotherapy (N = 108). The 32 patients who underwent surgery and chemotherapy had statistically higher incidence of all risk factors. Nonetheless, after 4-year follow-up they had less recurrences and deaths than the other patients.