Objective: To investigate the role of tumor persistence in patients submitted to irradiation therapy and radical hysterectomy.
Design: A retrospective analysis of prognostic factors.
Location: Hospital A.C. Camargo, São Paulo, Brazil, a private non-profitmaking foundation and tertiary referral centre.
Patients: A total of 629 cases of invasive squamous cell carcinoma of the cervix were studied. Criteria for inclusion in the study were: confirmed histological diagnosis of squamous cell carcinoma and no previous treatment (except for preoperative radiotherapy carried out at the Hospital A.C. Camargo itself). At the end of the follow-up period, 410 patients (65%) had no evidence of disease and 219 (34.8%) had died because of the tumor.
Intervention: The patients were submitted to radical surgery and radiation therapy, separately or in combination between 1953 and 1982.
Main outcomes measures: Multivariate analysis of the different variables was performed according to the Cox regression method.
Results: The variables of prognostic value were, in decreasing order of importance: the decade of patient admission (p = 0.0001), the modality of therapy employed (p = 0.0005), the presence of residual tumor in the surgical specimens (p = 0.0055) and the clinical stage of the disease (p = 0.0575).
Conclusion: Radiation therapy controlled a considerable number of local tumors and pelvic lymph nodes but not all of them in every patient. There is a specific group of patients for whom radical surgery is necessary to achieve control of the disease.