Invasive carcinoma of the cervix. Our experience with 42 patients

Forty two patients with invasive carcinoma of the cervix are presented. Patients ages ranged between 30 and 63 years (mean 46): 24 presented in stage I, 15 in stage II, 4 in stage III and 1 in stage IV. Twenty three patients had primary treatment by radical hysterectomy, 4 had preoperative radiotherapy followed by hysterectomy, 2 (Stage IA) were treated by total abdominal hysterectomy and bilateral salpingoophorectomy (TAH and BSO), 10 had radiation therapy as the primary treatment, and 2 had radio- combined with chemotherapy. Of the 24 (Stage I) patients, 22 (90.5%) are alive with no evidence of disease (NED). Of the 13 (stage II) patients, 10 (77%) are alive, 8 of them NED. All five patients in stages III and IV died of the disease (1-3 years following the diagnosis). Of the 42 patients, 16 (39%) were asymptomatic and the disease (81% stage I) was detected by routine Pap smear. The use of the routine Pap smear for the Jewish population in Israelis controversial, therefore our detection rate of cervical carcinoma by such a routine test in asymptomatic patients may imply the necessity for mass screening. However, other considerations as cost effectiveness should be taken into account.