[Evaluation of pre-radiotherapy staging laparotomy in cancer of the uterine cervix].

Staging laparotomy prior to radiotherapy was performed in 70 patients with cervix cancer. Biopsy proven para-aortic lymph node metastases were found in 16(22.9%) patients. Pelvic lymph node metastases were estimated by palpation at laparotomy and 36(51.4%) patients were thought to be positive. Other laparotomy findings were: invasion to the bladder muscle in 14, cul-de-sac metastasis in 10, adnexal metastasis in 2, other intrapelvic metastasis in 3, and positive peritoneal cytology in 9. At laparotomy several hemostatic clips were put on the serosal surfaces of the uterine wall in order to visualize the uterine contour in the localization X-ray films. By this method, six patients were proved to have uterine perforation at the time of small source insertion. Five-year survival rates for each clinical stage were: Stage I, 60%; II, 35.7%; III, 56.8%; and IV 0%. It seems that stage II is worse than stage III, but statistical differences were not found among stages I, II, and III. Three patients with para-aortic metastasis survived for more than four years. Late radiation complications occurred in 25(35.7%) of the patients. This complication rate was statistically higher than that of the patients who had not undergone staging laparotomy (21.1%).