Peter Hass1, Holm Eggemann2, Serban Dan Costa2, Atanas Ignatov3. 1. Department of Radiation Oncology, Universitätsklinikum Magdeburg, Magdeburg, Germany. 2. Department of Obstetrics and Gynecology, Otto-von-Guericke University, G.-Hauptmann Str. 35, 39108, Magdeburg, Germany. 3. Department of Obstetrics and Gynecology, Otto-von-Guericke University, G.-Hauptmann Str. 35, 39108, Magdeburg, Germany. atanas.ignatov@gmail.com.
Abstract
BACKGROUND: External beam radiation therapy (EBRT) with concomitant chemotherapy (cCT) (=RCT) plus intracavitary (±interstitial) brachytherapy (iBT) is standard of care for advanced cervical cancer. The aim of this study was to evaluate morbidity and survival outcome of simple adjuvant hysterectomy (AH) after EBRT/cCT and to compare it with the standard treatment. PATIENTS AND METHODS: Patients with FIGO stage III cervical cancer were treated with EBRT/cCT and then divided in two groups: group 1 was further treated with standard intracavitary/interstitial BT, while group 2 underwent AH. RESULTS: From 881 women with cervical cancer, 248 were eligible for analysis: 161 received iBT and 87 underwent AH. The median follow-up of the study was 53 months. Clinical and pathological characteristics were well balanced in the two groups. After EBRT/cCT, complete clinical response was observed in 121 (48.8%) of 246 patients. Clinical complete response was observed in 81 (50.3%) of 161 patients in group 1. At 6 weeks after EBRT/cCT, 40 (46.0%) of 87 patients in the surgery group had pathological complete response. Intra- and postoperative complications were observed in 10 (11.5%) of 87 cases. The rates of locoregional recurrence and metastasis were similar in both groups. Progression-free (PFS) and disease-specific overall survival (DOS) for these patients were similar between the control and surgery group. Interestingly, PFS and DOS were significantly improved by AH for the patients with residual tumor. CONCLUSION: AH could improve survival in patients with residual disease after RCT and is characterized by a low complication rate.
BACKGROUND: External beam radiation therapy (EBRT) with concomitant chemotherapy (cCT) (=RCT) plus intracavitary (±interstitial) brachytherapy (iBT) is standard of care for advanced cervical cancer. The aim of this study was to evaluate morbidity and survival outcome of simple adjuvant hysterectomy (AH) after EBRT/cCT and to compare it with the standard treatment. PATIENTS AND METHODS: Patients with FIGO stage III cervical cancer were treated with EBRT/cCT and then divided in two groups: group 1 was further treated with standard intracavitary/interstitial BT, while group 2 underwent AH. RESULTS: From 881 women with cervical cancer, 248 were eligible for analysis: 161 received iBT and 87 underwent AH. The median follow-up of the study was 53 months. Clinical and pathological characteristics were well balanced in the two groups. After EBRT/cCT, complete clinical response was observed in 121 (48.8%) of 246 patients. Clinical complete response was observed in 81 (50.3%) of 161 patients in group 1. At 6 weeks after EBRT/cCT, 40 (46.0%) of 87 patients in the surgery group had pathological complete response. Intra- and postoperative complications were observed in 10 (11.5%) of 87 cases. The rates of locoregional recurrence and metastasis were similar in both groups. Progression-free (PFS) and disease-specific overall survival (DOS) for these patients were similar between the control and surgery group. Interestingly, PFS and DOS were significantly improved by AH for the patients with residual tumor. CONCLUSION: AH could improve survival in patients with residual disease after RCT and is characterized by a low complication rate.
Authors: S Baffert; S Alran; V Fourchotte; M A Traore; C Simondi; P Mathevet; C Loustalot; C Binelli; I Jaffre; E Barranger; P F Dupre; G Ferron; G Houvenaeghel; J Leveque; P Descamps; G Body; D Raudrant; J M Classe Journal: Eur J Surg Oncol Date: 2015-10-27 Impact factor: 4.424
Authors: Kari Tanderup; Jacob Christian Lindegaard; Christian Kirisits; Christine Haie-Meder; Kathrin Kirchheiner; Astrid de Leeuw; Ina Jürgenliemk-Schulz; Erik Van Limbergen; Richard Pötter Journal: Radiother Oncol Date: 2016-08-20 Impact factor: 6.280
Authors: Renaud Mazeron; Lars U Fokdal; Kathrin Kirchheiner; Petra Georg; Noha Jastaniyah; Barbara Šegedin; Umesh Mahantshetty; Peter Hoskin; Ina Jürgenliemk-Schulz; Christian Kirisits; Jacob C Lindegaard; Wolfgang Dörr; Christine Haie-Meder; Kari Tanderup; Richard Pötter Journal: Radiother Oncol Date: 2016-07-07 Impact factor: 6.280
Authors: Esther R Nijhuis; Ate G J van der Zee; Bertha A in 't Hout; Jantine J Boomgaard; Joanne A de Hullu; Elisabeth Pras; Harry Hollema; Jan G Aalders; Hans W Nijman; Pax H B Willemse; Marian J E Mourits Journal: Int J Radiat Oncol Biol Phys Date: 2006-08-14 Impact factor: 7.038
Authors: Tanja Ignatov; Holm Eggemann; Elke Burger; Serban Dan Costa; Atanas Ignatov Journal: Breast Cancer Res Treat Date: 2017-02-23 Impact factor: 4.872
Authors: Myrna Candelaria; José Chanona-Vilchis; Lucely Cetina; Diana Flores-Estrada; Carlos López-Graniel; Aaron González-Enciso; David Cantú; Adela Poitevin; Lesbia Rivera; Jose Hinojosa; Jaime de la Garza; Alfonso Dueñas-Gonzalez Journal: Int Semin Surg Oncol Date: 2006-02-03