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  • Title: [Stage III cancer of the cervix. The diagnosis, treatment and prognosis in a series of 92 patients (author's transl)].
    Author: Heintz J.
    Journal: J Gynecol Obstet Biol Reprod (Paris); 1980; 9(6):695-704. PubMed ID: 7462574.
    Abstract:
    This study is of 92 patients who were treated for Stage III carcinoma of the cervix in the Henri Becquerel Centre. We have ruled out the 11 patients who refused to complete their treatment or who died before treatment started. The average age was 63 years. The Stage III cases were divided into 40 Stage III A and 41 Stage III B, with 10 who had urinary tract involvement. These were epidermoid carcinomata. The treatment was by external radiotherapy followed by superimposed radium therapy in 66 cases. 15 patients were treated by external radiotherapy alone. The lumboartic nodes were treated in the area that was irradiated in 5 patients. The actuarial figures for survival work out at 51 per cent at 5 years for Stage III A cases and 34 per cent for Stage III B cases. Pelvic recurrences were responsible for 87 per cent of the failures. In fact, in almost 87 per cent of the cases the area was not completely sterilised. The percentage of failures was higher in the group that had altered lymphograms. The prognosis was worst when the upper urinary tract was affected. All patients who had positive lymphograms or those that were suspicious of having lumboaortic nodes involved died. In the 15 patients who did not have added radium therapy there were 13 cases who were not sterilised and 1 that recurred at 13 months. In 32 per cent of cases the failures in the pelvis were associated with pathology in distant lymph nodes and/or with visceral metastases. We found 13 per cent of solitary metastases. Between 5 and 10 years the failure rate is 9 per cent with a level of 6.3 per cent of pelvic recurrences associated or not associated with metastases or even with complications. Our patients had 8 rectosigmoid complications of which 2 needed a diversion colostomy. There were 7 cases of cystitis after X-ray, in the majority of a benign nature, and 2 bony complications that recovered spontaneously. After a study of the diagnosis and treatment of Stage III cancer of the cervix, the discussion compares the results found in this study with those to be found in the literature.
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