ADENOCARCINOMA OF THE BODY OF THE UTERUS

TLDR

Preoperative radium and postoperative irradiation were administered when pelvic lymph nodes were involved in metastatic cancer. In 129 cases of uterine adenocarcinoma treated with Wertheim's hysterectomy and lymphadenectomy, five‑year survival was 71.5 % overall (74 % when the cervix was uninvolved), lymph node involvement occurred in 13.2 % of patients (11.2 % when the cervix was free), and survival improved to 36 % at five years for node‑positive patients receiving combined lymphadenectomy and external radiation, leading the authors to recommend lymphadenectomy only for poorly differentiated or deeply invasive tumors and postoperative irradiation when nodes are involved.

Abstract

Summary A series of 129 cases of adenocarcinoma of the uterus treated by Wertheim's hysterectomy and lymphadenectomy is reported. Preoperative radium was given together with postoperative irradiation when pelvic lymph nodes were involved in metastatic cancer. The five‐year survival was 71·5 per cent. This figure rose to 74 per cent when the growth did not involve the cervix. The incidence of lymph node involvement was 13·2 per cent, or 11·2 per cent when the cervix was free from growth. The incidence of node involvement was related to the degree of differentiation of the tumour and the depth of myometrial invasion. Thirty‐six per cent of patients with positive nodes survived 5 years when lymphadenectomy was combined with external radiation. When death occurred the metastatic deposits were usually outside the pelvis. It is concluded that lymphadenectomy need be performed only in patients with poorly differentiated and deeply invasive growth. Postoperative external irradiation is indicated if the nodes contain cancer.