[Postoperative radiotherapy of cervical cancer: complications and implications for the surgical indications].

In a retrospective study the incidence was determined of reversible and irreversible complications in 176 cases of cervical cancer stages I and II treated by operation and postoperative irradiation, in 329 cases of cervical cancer stages III and IV treated by irradiation alone. Severe, irreversible complications (fistulae) occurred in a significantly higher percentage of patients in the group given combined treatment (7.4%) compared with the group treated by irradiations alone (0.6%); p=0.01). The incidence of fistulae was even twice as high in the group of operated and irradiated patients with cervical cancer stages I and II than in the group of patients with cervical cancer stages III and IV treated by irradiation alone (3.2%). Hence, postoperative radiotherapy appears to be rather dangerous. Since primary irradiation achieves the same 5-year survival rate, but is connected with significantly fewer complications, it is pointed out that those cases of cervical cancer which seem to be technically operable, but will probably have to undergo postoperative irradiation, should better be treated by irradiation alone.