TY - JOUR T1 - Surgical Outcomes of Patients Undergoing Extrafascial Hysterectomy After Neoadjuvant Radiotherapy With or Without Chemotherapy for Locally Advanced Endometrial Cancer Clinically Extending to the Cervix or Parametria JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 1149 LP - 1154 DO - 10.1097/IGC.0000000000000614 VL - 27 IS - 6 AU - Michelle M. Boisen AU - J. Austin Vargo AU - Sushi Beriwal AU - Paniti Sukumvanich AU - Alexander B. Olawaiye AU - Joseph L. Kelley AU - Robert P. Edwards AU - Marilyn Huang AU - Madeleine Courtney-Brooks AU - John T. Comerci Y1 - 2017/07/01 UR - http://ijgc.bmj.com/content/27/6/1149.abstract N2 - Objectives Recent data have shown high rates of clinical and pathologic responses to neoadjuvant radiation therapy for locally advanced endometrial cancer. There are limited data on the surgical outcomes of these patients in the era of modern radiation and surgical techniques. We sought to characterize surgical outcomes after extrafascial hysterectomy in this population.Methods Patients with endometrial cancer of all histologies clinically involving the cervix or parametria treated with neoadjuvant brachytherapy followed by extrafascial hysterectomy from 1999 to 2014 were identified. Patient charts were reviewed for data regarding treatment characteristics and postoperative outcomes. Pearson χ2 and logistic regression analyses were used to assess correlations between surgical complications and treatment-related variables.Results Twenty-nine patients met inclusion criteria. Mean operating time for the cohort was 115 minutes. Mean estimated blood loss was 100 mL. No visceral injuries occurred. Mean length of hospital stay was 1 and 4 days for the minimally invasive and laparotomy groups, respectively. Rates of postoperative ileus, blood transfusion, wound infection, and readmission were 3%, 3%, 6%, and 3%, respectively. No case of prolonged urodynamic dysfunction was noted. The rate of vaginal complications was significantly higher in the group of patients who underwent minimally invasive surgery as compared with laparotomy (33% vs 5%, P < 0.041).Conclusions These data support adjuvant extrafascial hysterectomy after neoadjuvant radiotherapy for endometrial cancer with cervical or parametrial involvement as a safe and viable procedure, with low rates of postoperative complications. Extra care should be taken when closing the vaginal cuff to reduce the risk of vaginal cuff complications. ER -