Document Detail


Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer.
MedLine Citation:
PMID:  2351324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P less than 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy.
Authors:
A P Soisson; J T Soper; D L Clarke-Pearson; A Berchuck; G Montana; W T Creasman
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Gynecologic oncology     Volume:  37     ISSN:  0090-8258     ISO Abbreviation:  Gynecol. Oncol.     Publication Date:  1990 Jun 
Date Detail:
Created Date:  1990-07-13     Completed Date:  1990-07-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0365304     Medline TA:  Gynecol Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  390-5     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Combined Modality Therapy
Female
Humans
Hysterectomy / methods*
Lymph Nodes / pathology
Lymphatic Metastasis
Lymphedema / etiology
Middle Aged
Neoplasm Recurrence, Local
Radiation Injuries
Survival Analysis
Uterine Cervical Neoplasms / mortality,  radiotherapy*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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