Analysis of the effect of adjuvant radiotherapy on outcome and complications after radical hysterectomy in FIGO stage IB1 cervical cancer patients with intermediate risk factors

2014 ◽  
Vol 133 ◽  
pp. 61-62 ◽  
Author(s):  
K. Nakamura ◽  
T. Satoh ◽  
Y. Takei ◽  
S. Nagao ◽  
I. Sekiguchi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Cancer Patients ◽  
Radical Hysterectomy ◽  
Adjuvant Radiotherapy ◽  
Figo Stage ◽  
Intermediate Risk

scholarly journals Analysis of isolated loco-regional recurrence rate in intermediate risk early cervical cancer after a type C2 radical hysterectomy without adjuvant radiotherapy

2019 ◽  
Vol 29 (5) ◽  
pp. 874-878 ◽  
Author(s):  
Jacobus van der Velden ◽  
Constantijne H Mom ◽  
Luc van Lonkhuijzen ◽  
Ming Y Tjiong ◽  
Henrike Westerveld ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Adjuvant Radiotherapy ◽  
Regional Recurrence ◽  
Intermediate Risk ◽  
Viable Option ◽  
Risk Of Death ◽  
Time To Recurrence ◽  
Early Cervical Cancer

BackgroundThe efficacy of adjuvant radiotherapy in patients with intermediate risk early cervical cancer after radical hysterectomy is still under debate. Most guidelines recommend adjuvant radiotherapy, whereas others consider observation a viable option.ObjectiveTo investigate if patients with intermediate risk factors for cervical cancer who underwent radical hysterectomy may benefit from adjuvant radiotherapy.MethodsConsecutive patients with tumor confined to the cervix and intermediate risk factors (according to Sedlis), treated between January 1982 and December 2014 who were observed after a type C2 radical hysterectomy formed the basis for this study. The frequency of recurrences, specifically isolated loco-regional recurrences, and the risk of death from recurrences, were analyzed. Data were analyzed using SPSS, version 23.0 for WindowsResultsA total of 161 patients were included in the analysis. Median age was 40 (range 20–76). Stages IB1 and IB2 were seen in 87 (54%) and 74 patients (46%), respectively. Squamous cell and non-squamous histology was seen in 114 (70.8%) and 47 patients (29.2%), respectively. Of the 161 patients, 25 (15.5%) had recurrent disease, of whom nine had an isolated loco-regional recurrence (5.6%). Median time to recurrence for isolated loco-regional recurrences was 28 months (range 9–151). Treatment for an isolated loco-regional recurrence was radiotherapy (n = 4) and chemoradiotherapy (n = 5). Four patients (2.5%) died from disease as a result of an isolated loco-regional recurrence. Actuarial disease- specific survival was 93.0% for the total group. No variables were found that predicted an isolated loco-regional recurrence.DiscussionThe mortality from isolated loco-regional recurrence in patients with intermediate risk factors for cervical cancer who underwent only radical hysterectomy type C2 was 2.5%. Further studies should compare outcomes between patients who undergo a type C2 radical hysterectomy without adjuvant radiotherapy with those undergoing a less radical hysterectomy but with adjuvant radiotherapy.

Impact of the Addition of Concurrent Chemotherapy to Pelvic Radiotherapy in Surgically Treated Stage IB1-IIB Cervical Cancer Patients With Intermediate-Risk or High-Risk Factors: A 13-Year Experience

2013 ◽  
Vol 23 (3) ◽  
pp. 567-575 ◽  
Author(s):  
Mika Okazawa ◽  
Seiji Mabuchi ◽  
Fumiaki Isohashi ◽  
Osamu Suzuki ◽  
Yasuo Yoshioka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Prognostic Factors ◽  
High Risk ◽  
Cancer Patients ◽  
Risk Group ◽  
Figo Stage ◽  
High Risk Group ◽  
Intermediate Risk ◽  
Stromal Invasion

ObjectivesTo identify groups of patients who derive clinical benefit from postoperative adjuvant concurrent chemoradiotherapy (CCRT), we retrospectively investigated the survival outcomes of surgically treated early-stage cervical cancer patients.MethodsWe reviewed the medical records of 316 patients with FIGO stage IB1-IIB cervical cancer who had been treated with adjuvant radiotherapy (RT) (n = 124, RT group) or adjuvant CCRT (n = 192, CCRT group) after radical hysterectomy between January 1996 and December 2009. Of these, 187 patients displayed high-risk prognostic factors (high-risk group), and 129 displayed intermediate-risk prognostic factors (intermediate-risk group). Sixty patients with 1 intermediate-risk prognostic factor who received no adjuvant therapy were also identified and used as controls (NFT group). Survival was calculated using the Kaplan-Meier method and compared using the log-rank test.ResultsIn the high-risk group, adjuvant CCRT was significantly superior to RT alone with regard to recurrence rate, progression-free survival (PFS), and overall survival. In the intermediate-risk group, CCRT was superior to RT with regard to recurrence rate and PFS in patents with 2 or more risk factors. Among the patients with only 1 intermediate-risk factor, although no survival benefit of CCRT over RT was observed, addition of adjuvant treatment resulted in significantly improved PFS compared with the NFT group in patients with deep stromal invasion (log-rank, P = 0.012).ConclusionsPostoperative CCRT improved the prognosis of FIGO stage IB1-IIB cervical cancer patients in the high-risk group and patients who displayed 2 or more intermediate-risk factors. Patients who displayed deep stromal invasion alone also derived clinical benefit from adjuvant treatment.

Delayed adjuvant radiotherapy in early-stage cervical cancer with intermediate-risk features has a detrimental effect on survival that cannot be corrected by adjuvant chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6037-6037
Author(s):  
Joyson Kodiyan ◽  
Adel Guirguis ◽  
Hani Ashmalla
Keyword(s):  
Cervical Cancer ◽  
Adjuvant Chemotherapy ◽  
Radical Hysterectomy ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Positive Margin ◽  
Pelvic Lymphadenectomy ◽  
Intermediate Risk ◽  
Early Stage Disease ◽  
Early Stage Cervical Cancer

6037 Background: GOG-0263 is currently investigating the role of adjuvant chemotherapy (CT) concurrently with radiotherapy (RT) in patients with early stage cervical cancer that underwent radical hysterectomy and pelvic lymphadenectomy harboring intermediate risk features. We used a retrospective database to investigate whether adjuvant chemotherapy significantly influenced overall survival (OS), and whether its effectiveness is influenced by delays in radiotherapy. Methods: All data was obtained from the NCDB (National Cancer Database) and initially contained 115,747 cases of cervical cancer diagnosed between 2004 and 2015. Analyzed patients had early stage disease, received radical hysterectomy with pathologic stage I to IIA, and had intermediate risk features including size greater than 4 cm or lymphovascular invasion. All patients received adjuvant RT with or without CT. Cases with positive margin or nodes, with parametrial extension, or metastasis were excluded. Cases were weighted by inverse probability of treatment (CT) using clinical and socioeconomic variables, and analyzed for OS using multivariate models. Predictors of receiving CT were determined using multivariate logistic regression. Results: The final cohort was 557 patients with median follow-up of 43 months (range, 1.54-143.7). Median survival without CT (n = 244) versus with CT (n = 313) was 42.2 versus 43.9 months (HR 0.81, 95%CI 0.661-0.995, p = 0.045). Median time from diagnosis to RT was 91 days (range, 21-691), and predicted for inferior OS (p = 0.007). No significant interaction existed between RT delay and receipt of CT (p = 0.997). Cases with squamous histology were less likely to receive CT than adenocarcinoma histology (OR 0.345, 95%CI 0.159-0.725, p = 0.006). Conclusions: Poor survival outcomes are observed in patients with early stage cervical cancer harboring intermediate risk features when adjuvant radiotherapy is delayed. This outcome was not corrected by addition of chemotherapy.

scholarly journals Minimally Invasive Versus Open Surgery for Radical Hysterectomy Followed By Adjuvant Radiotherapy in Intermediate- or High-Risk Early-Stage Cancer of The Cervix: A Retrospective Study

2021 ◽  
Author(s):  
Qi-ying Zhang ◽  
Zi Liu ◽  
Ya-li Wang ◽  
Jing Zhang ◽  
Wen Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
High Risk ◽  
Minimally Invasive ◽  
Cancer Patients ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Time Interval ◽  
Significant Difference ◽  
The Impact

Abstract Background Postoperative radiotherapy (RT) or chemoradiotherapy (CRT) improves outcomes of cervical cancer patients with risk factors. Minimally invasive surgery (MIS) has an inferior survival than open radical hysterectomy (ORH), however, the impact of MIS on postoperative RT remains uncertain. The study compared the impacts of MIS versus ORH on delivering of adjuvant RT or CRT for intermediate- or high-risk early-stage cervical cancer. Methods Data on stage IB1-IIA2 patients who underwent radical hysterectomy and postoperative RT/CRT in our institution, from 2014 to 2017, were retrospectively collected. Patients with high or intermediate-risk factors who met the Sedlis criteria received postoperative pelvic external beam radiotherapy (50Gy/25f) with platinum-based chemotherapy (0–6 cycles) according to guidelines. Disease-free survival (DFS) and overall survival (OS) were compared in the two surgical groups. Results One hundred and twenty-nine patients eligible for the study (68 in ORH; 61 in MIS groups) had similar clinicopathologic features except for the stage (highest in MIS was IB1; IIA1 in ORH) and presence of lymph vascular space invasion (higher in MIS group). The median time interval from surgery to chemotherapy and to RT was shorter in the MIS group. Three-year DFS and OS were similar in both groups. Further sub-analysis indicated that the DFS and OS in intermediate/high-risk groups had no significant difference. Cox-multivariate analyses found that tumor size > 4 cm and time interval from surgery to RT beyond seven weeks were adverse independent prognostic factors for DFS. Conclusions In early-stage (IB1-IIA2) cervical cancer patients with intermediate or high-risk factors who received postoperative RT or CRT, no matter they received ORH or MIS as their primary treatment, the DFS and OS had no significant difference, despite TI from surgery to postoperative adjuvant therapy being shorter in the MIS group than ORH.

Sign in / Sign up

Export Citation Format

Share Document