Is Surgical Treatment an Option for Locally Advanced Cervical Cancer in the Presence of Central Residual Tumor after Chemoradiotherapy?
Journal
Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia
ISSN: 1806-9339
Titre abrégé: Rev Bras Ginecol Obstet
Pays: Brazil
ID NLM: 9214757
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
entrez:
29
2
2020
pubmed:
29
2
2020
medline:
5
1
2021
Statut:
ppublish
Résumé
To evaluate the outcomes of surgical treatment in patients with chemoradiotherapy (CRT)-resistant and locally advanced cervical cancer (LACC). Patients with LACC who underwent surgery due to resistance to CRT between 2005 and 2015 were reviewed retrospectively. Disease-free survival (DFS) and overall survival (OS) related factors were analyzed. A total of 23 patients were included in the study and the median age was 51 years old. A total of 14 patients (60.8%) experienced recurrence; among these recurrences, 8 of them were local, 5 were distant, 1 was both distant and local. A total of 9 patients (39%) died. The Median DFS and OS durations were 15 and 32 months, respectively. A total of 17 patients (74%) had undergone simple hysterectomy, 4 (17%) radical hysterectomy, and 2 (9%) total pelvic exenteration. Postoperative grade 3 and 4 complications were seen in 12 patients (52%). Macroscopic tumor presence in the pathology specimen was associated with distant recurrence and positive surgical margins with local recurrence (Log-Rank test In patients with LACC, hysterectomy is an option in the presence of a central residual tumor after CRT. However, the risk of grades 3 and 4 complications of performed surgery is high. The presence of macroscopic tumor in the pathology specimen and positive surgical margins are poor prognostic factors. The goal of the surgeon should be to achieve a negative surgical margin. It does not seem important if the surgery is simple or radical.
Identifiants
pubmed: 32107764
doi: 10.1055/s-0040-1701459
pmc: PMC10316869
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
35-42Informations de copyright
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.
Déclaration de conflit d'intérêts
The authors have no conflict of interests to declare.
Références
Clin Oncol (R Coll Radiol). 2010 Mar;22(2):140-6
pubmed: 20045300
Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1213-36
pubmed: 7713784
Ann Oncol. 2000 Apr;11(4):455-9
pubmed: 10847466
Int J Gynecol Cancer. 2014 Sep;24(7):1276-85
pubmed: 24987914
N Engl J Med. 1999 Apr 15;340(15):1154-61
pubmed: 10202166
Ann Pharmacother. 2005 Mar;39(3):516-22
pubmed: 15701781
Int J Gynaecol Obstet. 2002 Jul;78(1):79-91
pubmed: 12197489
Int J Radiat Oncol Biol Phys. 2013 Mar 1;85(3):604-8
pubmed: 22846413
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Int J Gynecol Cancer. 1999 Jul;9(4):295-301
pubmed: 11240782
J Clin Oncol. 2004 Aug 1;22(15):3113-9
pubmed: 15284262
World J Surg Oncol. 2009 Feb 16;7:19
pubmed: 19220882
Br J Cancer. 2008 Oct 21;99(8):1216-20
pubmed: 18854823
CA Cancer J Clin. 2013 Jan;63(1):11-30
pubmed: 23335087
J Clin Oncol. 2004 Jun 1;22(11):2207-13
pubmed: 15169810
Iran Red Crescent Med J. 2013 Dec;15(12):e10758
pubmed: 24693381
Asian Pac J Cancer Prev. 2016;17(S3):287-91
pubmed: 27165240
Cancer. 2008 Aug 15;113(4):743-9
pubmed: 18618500
Gynecol Oncol. 2005 Apr;97(1):126-35
pubmed: 15790448
Indian J Surg. 2015 Dec;77(Suppl 3):902-5
pubmed: 27011479
J Clin Oncol. 2008 Dec 10;26(35):5802-12
pubmed: 19001332
Radiother Oncol. 2012 Dec;105(3):305-12
pubmed: 23021793
J Cancer Res Ther. 2014 Apr-Jun;10(2):330-6
pubmed: 25022387
J Natl Compr Canc Netw. 2015 Apr;13(4):395-404; quiz 404
pubmed: 25870376
J Clin Oncol. 2004 Mar 1;22(5):872-80
pubmed: 14990643