| Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer. | |
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MedLine Citation:
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PMID: 2351324 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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A P Soisson; J T Soper; D L Clarke-Pearson; A Berchuck; G Montana; W T Creasman |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Gynecologic oncology Volume: 37 ISSN: 0090-8258 ISO Abbreviation: Gynecol. Oncol. Publication Date: 1990 Jun |
Date Detail:
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Created Date: 1990-07-13 Completed Date: 1990-07-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0365304 Medline TA: Gynecol Oncol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 390-5 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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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