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Abstract Background. To identify variable prognostic factors and analyze failure patterns in uterine cervix cancer after radical operation and adjuvant radiotherapy, a retrospective analysis was undertaken. Methods. We analyzed 124 patients with uterine cervix cancer, FIGO stage IB, IIA, and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radiotherapy between May 1985 and May 1995. Minimum follow-up period was 24 months. All these patients were treated with full-dose external radiotherapy using a linear accelerator or high-dose-rate intracavitary radiation. Results. Overall 5-year survival rate and relapse-free survival rate were 75.4% and 73.5%, respectively. Significant prognostic factors for relapse-free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, and vaginal resection margin involvement. By multivariate analysis, lymph node metastasis, tumor size, and vaginal resection margin involvement were significant prognostic factors. Treatment-related failure occurred in 33 cases. In stage IIB, 5-year relapse-free survival rate was only 56%, and 9 of 22 patients had recurrence. Conclusion. Postoperative radiotherapy results are good for patients with relatively low risk factors, but the results are poor for patients with multiple high-risk factors or stage IIB. To control recurrence for patients with high-risk factors, postoperative adjuvant radiotherapy alone is not a sufficient treatment method. Considering cost-effectiveness, it may be reasonable to treat with primary radical radiotherapy for patients with stage IIB cervical cancer and poor prognostic factors instead of a radical operation and adjuvant radiotherapy or chemotherapy regimen. Further investigation should be done.
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