Failure of radical hysterectomy in early invasive cancer cervix: an A. H. regional cancer centre experience (original) (raw)
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Radical hysterectomy and pelvic lymphadenectomy for carcinoma of the cervix
Cancer
patients with carcinoma of the cervix were treated a t the National Cancer Institute with radical hysterectomy and bilateral pelvic lymphadenectomy. A total cumulative 5-year survival of 83.5% was obtained. Fourteen patients classified as failures to previous radiotherapy, with a 5-year survival of 8596, were in this group. Nine patients with adenocarcinoma survived at a rate similar to the patients with epidermoid carcinoma. Despite excision of all paracervical tissue en bloc and the taking of 3-to 5-cm vaginal cuff, the local recurrence rate was 14%. T h e cause of tumor death was most often related to the combination of local recurrence and metastases. I n patients with negative pelvic nodes, the 5-year survival was 91% while in the presence of positive pelvic nodes the 5-year survival was 66%. T h e in-hospital mortality rate was 2.7%. No patient was lost to follow-up. Complications in this series where one third of the patients had been treated previously with irradiation or surgery were related primarily to the urinary tract, with a n 8 % incidence of urinary fistulae, 7% incidence of ureteral stricture, and 8% incidence of atonic bladder. Radical hysterectomy is admittedly a technically difficult operation but the complications can be minimized with proper patient selection, and survival may be obtained which is equal to, or superior to, other reported treatment modalities. ROM 1954 to 1969, OVER 2,000 PATIENTS
Survival in cervix cancer patients treated with radiotherapy followed by radical surgery
European Journal of Surgical Oncology (EJSO), 2005
Aim. To determine the incidence and predictive value of residual disease in the hysterectomy specimens of cervical cancer patients treated with primary radiotherapy, with or without chemotherapy, followed by surgery and to determine whether pathologically confirmed residual disease is a surrogate marker of outcome.
Gynecologic Oncology, 1989
In a retrospective study conducted at the University of Alabama at Birmingham, the University of Michigan, and the Mayo Clinic, 185 patients with previously untreated FIG0 stage IB and IIA squamous cell carcinoma of the cervix were found to have nodal metastasis at the time of radical hysterectomy and pelvic lymphadenectomy. Of these patients, 103 received adjuvant pelvic irradiation. Cancer recurred in 76 patients; the median time to recurrence was 3.1 years. The prognostic significance of patient age, clinical stage, lesion diameter, number and location of nodal metastases, and use of adjuvant radiation therapy was determined by multivariate analysis. Only patient age (P = 0.0006), lesion diameter (P < O.OOOl), and number of nodal metastases (P = 0.0004) were noted to be significant factors in determining overall survival. Rates of recurrence were also related to these factors. Employment of these significant variables led to identification of four risk groups. In general, patients with small cervical lesions (diameter < 1 cm) and no more than two nodes with metastases fell into the low-risk category; those patients with large cervical lesions (diameter > 4 cm) and more than two involved nodes fell into the high-risk category. All other patients were categorized into intermediate-risk groups. Ten-year survival was 92% in the low-risk group (n = 13), 70% in the low-intermediate-risk group (n = 66), 56% in the high-intermediate-risk group (n = 66), and 13% in the high-risk group (n = 20). This risk group classification identifies subgroups of early-stage cervical carcinoma patients found to have nodal metastasis at the time of radical hysterectomy that warrant appropriately selected adjuvant therapy. 0 1989 Academic press, Inc.
1987
In recent years there has been an increasing awareness that radical hysterectomy and pelvic lymphadenectomy can play an important role in the management of early invasive cervical cancer. The present report presents 224 patients with early cervical cancer managed by radical hysterectomy and pelvic lymphadenectomy in a gynecologic oncology training program at the University of Miami School of Medicine. Our operative mortality is 0.8% and our primary fistula rate is 1.3%. The survival rate as calculated by the life table method is 87%. A review of the recent literature as to the management of early cervical cancer both by radical hysterectomy and pelvic lymphadenectomy and by radical radiotherapy is presented. We have shown that not only does radical hysterectomy and pelvic lymphadenectomy have definite advantages for most patients with early invasive cancer of the cervix, but that such procedures can be carried out in a gynecologic oncology training program with a minimum morbidity and mortality.
Radical hysterectomy and pelvic lymphadenectomy for carcinoma of the uterine cervix
Cancer, 1971
patients with carcinoma of the cervix were treated a t the National Cancer Institute with radical hysterectomy and bilateral pelvic lymphadenectomy. A total cumulative 5-year survival of 83.5% was obtained. Fourteen patients classified as failures to previous radiotherapy, with a 5-year survival of 8596, were in this group. Nine patients with adenocarcinoma survived at a rate similar to the patients with epidermoid carcinoma. Despite excision of all paracervical tissue en bloc and the taking of 3-to 5-cm vaginal cuff, the local recurrence rate was 14%. T h e cause of tumor death was most often related to the combination of local recurrence and metastases. I n patients with negative pelvic nodes, the 5-year survival was 91% while in the presence of positive pelvic nodes the 5-year survival was 66%. T h e in-hospital mortality rate was 2.7%. No patient was lost to follow-up. Complications in this series where one third of the patients had been treated previously with irradiation or surgery were related primarily to the urinary tract, with a n 8 % incidence of urinary fistulae, 7% incidence of ureteral stricture, and 8% incidence of atonic bladder. Radical hysterectomy is admittedly a technically difficult operation but the complications can be minimized with proper patient selection, and survival may be obtained which is equal to, or superior to, other reported treatment modalities. ROM 1954 to 1969, OVER 2,000 PATIENTS
Bangladesh Medical Research Council Bulletin, 2011
One hundred and twenty patients with FIGO stage Ib-IIa cervical cancer who had radical hysterectomy prior to January 2003 in different hospitals of Bangladesh and thereafter received external beam pelvic radiotherapy (RT) at National Institute of Cancer Research and Hospital, Dhaka were studied. Until December 2007, 50 (42%) patients developed recurrence. Thirty-four (70%) patients experienced local recurrence, 13 (26%) distant recurrence and 2 (4%) both local and distant recurrence. Of 15 patients with distant metastasis, 6 (40%) experienced it in extra-pelvic lymph nodes. The median time to recurrence was 19 months (range 6-120 months) for local failure, 33 months (range 12-108 months) for distant failure and 25 months (range 13-36 months) for those with both local and distant failure. Eighty percent recurrences occurred within 36 months. There was significant correlation between lymph node metastasis and recurrence. All 5 (100%) patients with adenocarcinoma who had positive nodes experienced local recurrence compared with 18 of 49 (37%) squamous cell carcinoma patients with positive nodes. Recurrence more than 5 years after treatment developed in 5 (4%) patients. Mentionable, 4 (80%) out of 5 patients with late recurrence had squamous cell carcinoma with negative pelvic nodes.
Sao Paulo Medical Journal, 1998
OBJECTIVE: To investigate the role of tumor persistence in patients submitted to irradiation therapy and radical hysterectomy. DESIGN: A retrospective analysis of prognostic factors. LOCATION: Hospital A.C. Camargo, São Paulo, Brazil, a private non-profitmaking foundation and tertiary referral centre. PATIENTS: A total of 629 cases of invasive squamous cell carcinoma of the cervix were studied. Criteria for inclusion in the study were: confirmed histological diagnosis of squamous cell carcinoma and no previous treatment (except for preoperative radiotherapy carried out at the Hospital A.C. Camargo itself). At the end of the follow-up period, 410 patients (65%) had no evidence of disease and 219 (34.8%) had died because of the tumor. INTERVENTION: The patients were submitted to radical surgery and radiation therapy, separately or in combination between 1953 and 1982. MAIN OUTCOMES MEASURES: Multivariate analysis of the different variables was performed according to the Cox regression...
Berkala Kedokteran, 2021
Cervical cancer is a gynecologic disease that has a high level of malignancy and is a major cause of death from cancer in women. To be used as educational material for patients with cervical carcinoma when if there is known outcome of radical hysterectomy in patients with IB-IIA cervical carcinoma, it can be used as a basic data to know the success rate of radical hysterectomy.The sample was collected by consecutive sampling and we found a total of 55 IB-IIA cervical carcinoma patients who underwent a radical hysterectomy. The samples that met the inclusion criteria are 30 people. Data analysis using Chi-square/Fisher method (significant pvalue <0.05).In this study, 16.7% of patients with cervical carcinoma from IB to IIA died in 3 years after radical hysterectomy was performed. The average age of patients with stage IB to IIA cervical carcinoma was 48.03 ± 12.21 years with ages ranging from 23 to 78 years. Stage IIA is 16 times more significantly at risk for mortality in cervical carcinoma patients than stage IB. The 3-year survival rate for patients with stage IB to IIA cervical carcinoma after radical hysterectomy was 83.3% with an average life span of 32.8 months. Patients with stage IB to IIA cervical carcinoma after radical hysterectomy have an average disease-free interval (DFI) of 33.0 ± 5.74 months.
Asian Pacific Journal of Cancer Prevention, 2015
Background: To evaluate the rate of pathologic high-risk factors, intermediate-risk factors, and treatment outcomes in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy (RHPL). Materials and Methods: Medical records of stage IA-IIA1 cervical cancer patients who underwent RHPL during the 2006 to 2012 time period and patient follow-up data until December 2013 were reviewed. Results: Of 331 patients, 52 women (15.7%) had pathologic high-risk factors and 59 women (17.8%) had intermediate-risk factors without high-risk factors. All studied patients had an initial complete response. At median follow-up time of 40.9 months (range 1-103.3 months) and mean follow-up time of 43.3±25.3 months, 37 women had disease recurrence and 4 women had died of disease. The most common site of recurrence was the pelvis (64.8%). Fiveyear and 10-year disease free survival rates were 96.1% and 91.5%, respectively. Five-year and 10-year overall survival rates were 100% and 99.4%, respectively. Independent factors related to recurrence were pelvic node metastasis (odds ratio [OR], 2.670; 95%CI, 1.001-7.119), and >1/3 cervical stromal invasion (OR, 3.763; 95%CI, 1.483-9.549). Conclusions: The rates of pathologic high-risk and intermediate-risk factors should be considered and disclosed when counseling patients regarding primary treatment by RHPL. Oncologic outcomes of primary surgical treatment for early-stage cervical carcinoma were found to be excellent.