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Prognostic analysis of uterine cervical cancer treated with postoperative radiotherapy: importance of positive or close parametrial resection margin.

Kim YJ, Lee KJ, Park KR, Kim J, Jung W, Lee R, Kim SC, Moon HS, Ju W, Kim YH, Lee J - Radiat Oncol J (2015)

Bottom Line: PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study.Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT.Therefore, additional treatments to improve local control such as radiation boosting need to be considered.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To analyze prognostic factors for locoregional recurrence (LRR), distant metastasis (DM), and overall survival (OS) in cervical cancer patients who underwent radical hysterectomy followed by postoperative radiotherapy (PORT) in a single institute.

Materials and methods: Clinicopathologic data of 135 patients with clinical stage IA2 to IIA2 cervical cancer treated with PORT from 2001 to 2012 were reviewed, retrospectively. Postoperative parametrial resection margin (PRM) and vaginal resection margin (VRM) were investigated separately. The median treatment dosage of external beam radiotherapy (EBRT) to the whole pelvis was 50.4 Gy in 1.8 Gy/fraction. High-dose-rate vaginal brachytherapy after EBRT was given to patients with positive or close VRMs. Concurrent platinum-based chemoradiotherapy (CCRT) was administered to 73 patients with positive resection margin, lymph node (LN) metastasis, or direct extension of parametrium. Kaplan-Meier method and log-rank test were used for analyzing LRR, DM, and OS; Cox regression was applied to analyze prognostic factors.

Results: The 5-year disease-free survival was 79% and 5-year OS was 91%. In univariate analysis, positive or close PRM, LN metastasis, direct extension of parametrium, lymphovascular invasion, histology of adenocarcinoma, and chemotherapy were related with more DM and poor OS. In multivariate analysis, PRM and LN metastasis remained independent prognostic factors for OS.

Conclusion: PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study. Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT. Therefore, additional treatments to improve local control such as radiation boosting need to be considered.

No MeSH data available.


Related in: MedlinePlus

Overall survival for 7 patients with positive or close parametrial resection margin (RM) and 128 patients without positive or close parametrial RM.
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Figure 1: Overall survival for 7 patients with positive or close parametrial resection margin (RM) and 128 patients without positive or close parametrial RM.

Mentions: The 5-year progression-free survival and OS were 79% and 91%, respectively. The 5-year OS of patients with positive or close PRM was 19% (Fig. 1). Treatment failure occurred in 29 patients (21%) in the following groups: 1, 2, 1, 6, and 19 cases of local recurrence along with (n = 1), local recurrence along with DM (n = 2), regional recurrence alone (n = 1), regional recurrence along with DM (n = 6), and DM alone (n = 19), respectively. Metastases were found in lung (n = 13), para-aortic LN (n = 6), and peritoneum (n = 6).


Prognostic analysis of uterine cervical cancer treated with postoperative radiotherapy: importance of positive or close parametrial resection margin.

Kim YJ, Lee KJ, Park KR, Kim J, Jung W, Lee R, Kim SC, Moon HS, Ju W, Kim YH, Lee J - Radiat Oncol J (2015)

Overall survival for 7 patients with positive or close parametrial resection margin (RM) and 128 patients without positive or close parametrial RM.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493422&req=5

Figure 1: Overall survival for 7 patients with positive or close parametrial resection margin (RM) and 128 patients without positive or close parametrial RM.
Mentions: The 5-year progression-free survival and OS were 79% and 91%, respectively. The 5-year OS of patients with positive or close PRM was 19% (Fig. 1). Treatment failure occurred in 29 patients (21%) in the following groups: 1, 2, 1, 6, and 19 cases of local recurrence along with (n = 1), local recurrence along with DM (n = 2), regional recurrence alone (n = 1), regional recurrence along with DM (n = 6), and DM alone (n = 19), respectively. Metastases were found in lung (n = 13), para-aortic LN (n = 6), and peritoneum (n = 6).

Bottom Line: PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study.Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT.Therefore, additional treatments to improve local control such as radiation boosting need to be considered.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To analyze prognostic factors for locoregional recurrence (LRR), distant metastasis (DM), and overall survival (OS) in cervical cancer patients who underwent radical hysterectomy followed by postoperative radiotherapy (PORT) in a single institute.

Materials and methods: Clinicopathologic data of 135 patients with clinical stage IA2 to IIA2 cervical cancer treated with PORT from 2001 to 2012 were reviewed, retrospectively. Postoperative parametrial resection margin (PRM) and vaginal resection margin (VRM) were investigated separately. The median treatment dosage of external beam radiotherapy (EBRT) to the whole pelvis was 50.4 Gy in 1.8 Gy/fraction. High-dose-rate vaginal brachytherapy after EBRT was given to patients with positive or close VRMs. Concurrent platinum-based chemoradiotherapy (CCRT) was administered to 73 patients with positive resection margin, lymph node (LN) metastasis, or direct extension of parametrium. Kaplan-Meier method and log-rank test were used for analyzing LRR, DM, and OS; Cox regression was applied to analyze prognostic factors.

Results: The 5-year disease-free survival was 79% and 5-year OS was 91%. In univariate analysis, positive or close PRM, LN metastasis, direct extension of parametrium, lymphovascular invasion, histology of adenocarcinoma, and chemotherapy were related with more DM and poor OS. In multivariate analysis, PRM and LN metastasis remained independent prognostic factors for OS.

Conclusion: PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study. Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT. Therefore, additional treatments to improve local control such as radiation boosting need to be considered.

No MeSH data available.


Related in: MedlinePlus