Radical hysterectomy after chemoradiation in FIGO stage III cervical cancer patients versus chemoradiation and brachytherapy: Complications and 3-years survival
Radical hysterectomy after chemoradiation in FIGO stage III cervical cancer patients versus chemoradiation and brachytherapy: Complications and 3-years survival
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DOI：
10.1016/j.ejso.2016.05.011
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发表时间：
2016-10-01
期刊：
影响因子：
3.8
通讯作者：
Scambia, G.
中科院分区：
文献类型：
--
作者：
Fanfani, F.;Vizza, E.;Scambia, G.
背景资料：比较模式和早期和晚期并发症的发生率，以及生存结果在FIGO第III期宫颈癌患者接受根治性子宫切除术后化疗-放疗（CT-RT）vs. chemo-radiation单独。方法：1996年5月至2013年4月期间，150 FIGO阶段DI宫颈癌患者进行了治疗。按治疗方式分为标准治疗组（A组）77例，放化疗后子宫切除组（B组）73例。我们观察到B组的术中和治疗相关的早期泌尿和胃肠道并发症低于A组（p < 0.001）。仅B组记录了血管并发症（p < 0.001）。我们发现A组的局部复发率明显高于B组（p < 0.002）。我们在A组中登记了29例死亡，在B组中登记了22例死亡（p = 0.021）。3年无瘤生存率A组为62.9%，B组为68.3 A组和B组的3年总生存率分别为63.2%和67.7结论：CT-RT后行根治性子宫切除术是治疗晚期宫颈癌的有效方法。应进行进一步的前瞻性和随机研究，以解决有关标准方法的问题，以及不同类型的并发症如何影响生活质量。(C)2016爱思唯尔有限公司版权所有
Background: To compare patterns and rates of early and late complications, and survival outcome in FIGO stage III cervical cancer patients underwent to radical hysterectomy after chemo-radiation (CT-RT) vs. chemo-radiation alone.Methods: Between May 1996 and April 2013 150 FIGO stage DI cervical cancer patients were treated. We divide patients according to type of treatment: 77 were submitted to standard treatment (Group A), and 73 to completion hysterectomy after chemo-radiation (Group B).Results: The baseline characteristics of the 2 groups were superimposable. We observed lower intra-operative and treatment-related early urinary and gastro-intestinal complications in Group B with respect to Group A (p < 0.001). Vascular complications were registered only in Group B (p < 0.001). We found a significantly higher rate of local recurrences in the Group A than in the Group B (p < 0.002). We registered 29 deaths in the Group A and 22 in the Group B (p = 0.021). The 3-years disease-free survival rate in the Group A and in the Group B was 62.9% and 68.3%, respectively (p = 0.686), and the 3-years overall survival rate in the Group A and in the Group B was 63.2% and 67.7%, respectively (p = 0.675).Conclusions: This study confirms that radical hysterectomy after CT-RT is an effective therapeutic approach for advanced cervical cancer. Further prospective and randomized studies should be performed in order to solve the question about the standard approach, and how the different pattern of complication could impact on the quality of life. (C) 2016 Elsevier Ltd. All rights reserved.