The combination of radiotherapy and surgery in the treatment of carcinoma of the uterine cervix.

In the Department of Radiotherapy and Oncology at Oxford, 1303 patients were registered between 1950 and 1975 with a diagnosis of carcinoma of the uterus; from these, 883 cases of carcinoma of the uterine cervix could be identified with certainty. Each patient's full clinical record was established from multiple hospital notes, operating theatre records, histopathological report files and so on. A uniform classification, based on the TNM system, was used for all patients. A data file, suitable for computer analysis, was established which contained all the available data. Analysis revealed that all patients could be divided into two distinct groups that had been prospectively determined and that the allocation achieved was random. The results, by various methods of analysis, show consistently that a policy of radical radiotherapy combined with radical surgery gave an increased survival rate, and a decreased mortality rate from cancer when compared with a treatment policy of only radical radiotherapy. During the 25 years being reviewed there was a progressive increase in the number of young patients with cancer of the uterine cervix in the early stages of disease at presentation and in the survival of patients with the early stages of invasive cancer.