Prognostic factors for distant metastasis in carcinoma of the cervix with endometrial extension

From 1959 through 1989, a total of 231 patients with carcinoma of cervix extending to the endometrial cavity were treated with irradiation and brachytherapy at the Mallinckrodt institute of Radiology, St. Louis, Mo. Twenty-four patients received implant treatment using a technique similar to that used for primary endometriai cancer (Simon-Heyman technique) at the treating physician's discretion. Multivariate analysis using distant metastasis as the end point was performed to investigate possible contributing prognostic factors. Distant metastasis occurred in 88 (42%) of 207 patients in whom capsules were not used as part of intracavitary implant and in six (25%) of 24 patients treated with capsules. The incidence of distant metastasis in patients with cervical cancer extending into the endometrial cavity was linked to the prognostic factors of pelvic tumor control and tumor stage. Simon-Heyman capsule packing as part of intracavitary brachytherapy contributes to the reduction of distant metastasis; however, this observation needs to be validated in a larger-scale prospective clinical study.