RT Journal Article
SR Electronic
T1 Results of Surgery After Concurrent Chemoradiotherapy in Advanced Cervical Cancer: Comparison of Extended Hysterectomy and Extrafascial Hysterectomy
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 268-275
OP 268-275
DO 10.1111/IGC.0b013e3181c9e385
VO 20
IS 2
A1 Stéphanie Motton
A1 Gilles Houvenaeghel
A1 Martine Delannes
A1 Denis Querleu
A1 Marc SoulÉ-Tholy
A1 Jean Hoff
A1 Pierre Lèguevaque
YR 2010
UL http://ijgc.bmj.com/content/20/2/268-275.abstract
AB Objectives: The primary objective of this study was to compare disease-free survival (DFS) and overall survival (OS) of patients with and without completion surgery. The secondary objective was to compare DFS and OS of patients who had had systematic simple extrafascial hysterectomy or extended hysterectomy. The other objectives were to compare early and late complications with and without completion surgery and between the various surgical techniques.Methods: One hundred seventy-one patients with advanced cervical cancer were included in a retrospective, multicenter series.Results: The rate of pelvic control was 81.29% in our study after chemoradiotherapy, but histological residual cervical tumor persisted in nearly half of cases (49.71%). After a mean follow-up of 33 months, OS and DFS were not significantly higher in surgically treated patients, nor was the complication rate higher. Overall survival and DFS were not better after radical hysterectomy than after extrafascial hysterectomy. Statistically significant predictors of survival were clinical stage, tumor size, node extension, and residual tumor after chemoradiotherapy.Conclusion: There is no consensus regarding the maximal residual tumor volume after chemoradiotherapy suitable for surgery as there is no reliable imaging yet. Therefore, extrafascial hysterectomy with bilateral pelvic lymphadenectomy seems as a reasonable option if there are histological factors suggesting poor prognosis.