Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy
Identifieur interne : 003E87 ( Istex/Corpus ); précédent : 003E86; suivant : 003E88Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy
Auteurs : James V. Fiorica ; William S. Roberts ; Harvey Greenberg ; Mitchel S. Hoffman ; James P. Lapolla ; Denis CavanaghSource :
- Gynecologic Oncology [ 0090-8258 ] ; 1990.
Abstract
Morbidity and survival patterns were reviewed in 50 patients who underwent radical hysterectomy, pelvic lymphadenectomy, and adjuvant postoperative pelvic radiotherapy for invasive cervical cancer. Ninety percent of the patients were FIGO stage IB, and 10% were clinical stage IIA or IIB. Indications for adjuvant radiotherapy included pelvic lymph node metastasis, large volume, deep stromal penetration, lower uterine segment involvement, or capillary space involvement. Seventy-two percent of the patients had multiple high-risk factors. An average of 4700 cGy of whole-pelvis radiotherapy was administered. Ten percent of the patients suffered major gastrointestinal complications, 14% minor gastrointestinal morbidity, 12% minor genitourinary complications, one patient a lymphocyst, and one patient lymphed-ema. Of the five patients with major gastrointestinal morbidity, all occurred within 12 months of treatment. Three patients required intestinal bypass surgery for distal ileal obstructions and all are currently doing well and free of disease. All of the patients who developed recurrent disease had multiple, high-risk factors. The median time of recurrence was 12 months. All patients recurred within the radiated field. Actuarial survival was 90% and disease-free survival 87% at 70 months. It is our opinion that the morbidity of postoperative pelvic radiotherapy is acceptable, and benefit may be gained in such a high-risk patient population.
Url:
DOI: 10.1016/0090-8258(90)90139-C
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Roberts</name><affiliation><mods:affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</mods:affiliation></affiliation></author><author><name sortKey="Greenberg, Harvey" sort="Greenberg, Harvey" uniqKey="Greenberg H" first="Harvey" last="Greenberg">Harvey Greenberg</name><affiliation><mods:affiliation>Division of Radiation Oncology, Department of Radiology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</mods:affiliation></affiliation></author><author><name sortKey="Hoffman, Mitchel S" sort="Hoffman, Mitchel S" uniqKey="Hoffman M" first="Mitchel S." last="Hoffman">Mitchel S. 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Lapolla</name><affiliation><mods:affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</mods:affiliation></affiliation></author><author><name sortKey="Cavanagh, Denis" sort="Cavanagh, Denis" uniqKey="Cavanagh D" first="Denis" last="Cavanagh">Denis Cavanagh</name><affiliation><mods:affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:853C5D1007E2A2DA5E3CD9DE932605DFCCC5888C</idno><date when="1990" year="1990">1990</date><idno type="doi">10.1016/0090-8258(90)90139-C</idno><idno type="url">https://api.istex.fr/document/853C5D1007E2A2DA5E3CD9DE932605DFCCC5888C/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">003E87</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">003E87</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy</title><author><name sortKey="Fiorica, James V" sort="Fiorica, James V" uniqKey="Fiorica J" first="James V." last="Fiorica">James V. Fiorica</name><affiliation><mods:affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USADivision of Radiation Oncology, Department of Radiology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</mods:affiliation></affiliation></author><author><name sortKey="Roberts, William S" sort="Roberts, William S" uniqKey="Roberts W" first="William S." last="Roberts">William S. Roberts</name><affiliation><mods:affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</mods:affiliation></affiliation></author><author><name sortKey="Greenberg, Harvey" sort="Greenberg, Harvey" uniqKey="Greenberg H" first="Harvey" last="Greenberg">Harvey Greenberg</name><affiliation><mods:affiliation>Division of Radiation Oncology, Department of Radiology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</mods:affiliation></affiliation></author><author><name sortKey="Hoffman, Mitchel S" sort="Hoffman, Mitchel S" uniqKey="Hoffman M" first="Mitchel S." last="Hoffman">Mitchel S. Hoffman</name><affiliation><mods:affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</mods:affiliation></affiliation></author><author><name sortKey="Lapolla, James P" sort="Lapolla, James P" uniqKey="Lapolla J" first="James P." last="Lapolla">James P. Lapolla</name><affiliation><mods:affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</mods:affiliation></affiliation></author><author><name sortKey="Cavanagh, Denis" sort="Cavanagh, Denis" uniqKey="Cavanagh D" first="Denis" last="Cavanagh">Denis Cavanagh</name><affiliation><mods:affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Gynecologic Oncology</title><title level="j" type="abbrev">YGYNO</title><idno type="ISSN">0090-8258</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1990">1990</date><biblScope unit="volume">36</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="343">343</biblScope><biblScope unit="page" to="347">347</biblScope></imprint><idno type="ISSN">0090-8258</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0090-8258</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Morbidity and survival patterns were reviewed in 50 patients who underwent radical hysterectomy, pelvic lymphadenectomy, and adjuvant postoperative pelvic radiotherapy for invasive cervical cancer. Ninety percent of the patients were FIGO stage IB, and 10% were clinical stage IIA or IIB. Indications for adjuvant radiotherapy included pelvic lymph node metastasis, large volume, deep stromal penetration, lower uterine segment involvement, or capillary space involvement. Seventy-two percent of the patients had multiple high-risk factors. An average of 4700 cGy of whole-pelvis radiotherapy was administered. Ten percent of the patients suffered major gastrointestinal complications, 14% minor gastrointestinal morbidity, 12% minor genitourinary complications, one patient a lymphocyst, and one patient lymphed-ema. Of the five patients with major gastrointestinal morbidity, all occurred within 12 months of treatment. Three patients required intestinal bypass surgery for distal ileal obstructions and all are currently doing well and free of disease. All of the patients who developed recurrent disease had multiple, high-risk factors. The median time of recurrence was 12 months. All patients recurred within the radiated field. Actuarial survival was 90% and disease-free survival 87% at 70 months. It is our opinion that the morbidity of postoperative pelvic radiotherapy is acceptable, and benefit may be gained in such a high-risk patient population.</div></front></TEI><istex><corpusName>elsevier</corpusName><keywords><teeft><json:string>radiotherapy</json:string><json:string>morbidity</json:string><json:string>adjuvant</json:string><json:string>node</json:string><json:string>radical hysterectomy</json:string><json:string>postoperative</json:string><json:string>cervix</json:string><json:string>gynecol</json:string><json:string>metastasis</json:string><json:string>cervical</json:string><json:string>hysterectomy</json:string><json:string>uterine</json:string><json:string>carcinoma</json:string><json:string>survival rate</json:string><json:string>postoperative adjuvant</json:string><json:string>recurrence</json:string><json:string>adverse prognostic factors</json:string><json:string>gynecologic oncology</json:string><json:string>cervical cancer</json:string><json:string>cervical carcinoma</json:string><json:string>complication rate</json:string><json:string>postoperative radiotherapy</json:string><json:string>pelvic lymphadenectomy</json:string><json:string>actuarial survival</json:string><json:string>lymph</json:string><json:string>complication</json:string><json:string>pelvic</json:string><json:string>bowel obstruction</json:string><json:string>adverse factors</json:string><json:string>lymph node metastasis</json:string><json:string>presidential panel</json:string><json:string>annual meeting</json:string><json:string>gynecologic oncologists</json:string><json:string>pelvic node metastasis</json:string><json:string>stromal penetration</json:string><json:string>radiation doses</json:string><json:string>radiation therapy</json:string><json:string>survival patterns</json:string><json:string>pelvic radiation</json:string><json:string>median time</json:string></teeft></keywords><author><json:item><name>James V. Fiorica M.D.</name><affiliations><json:string>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USADivision of Radiation Oncology, Department of Radiology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</json:string></affiliations></json:item><json:item><name>William S. Roberts M.D.</name><affiliations><json:string>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</json:string></affiliations></json:item><json:item><name>Harvey Greenberg M.D.</name><affiliations><json:string>Division of Radiation Oncology, Department of Radiology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</json:string></affiliations></json:item><json:item><name>Mitchel S. Hoffman M.D.</name><affiliations><json:string>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</json:string></affiliations></json:item><json:item><name>James P. LaPolla M.D.</name><affiliations><json:string>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</json:string></affiliations></json:item><json:item><name>Denis Cavanagh M.D.</name><affiliations><json:string>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</json:string></affiliations></json:item></author><language><json:string>eng</json:string></language><originalGenre><json:string>Full-length article</json:string></originalGenre><abstract>Morbidity and survival patterns were reviewed in 50 patients who underwent radical hysterectomy, pelvic lymphadenectomy, and adjuvant postoperative pelvic radiotherapy for invasive cervical cancer. Ninety percent of the patients were FIGO stage IB, and 10% were clinical stage IIA or IIB. Indications for adjuvant radiotherapy included pelvic lymph node metastasis, large volume, deep stromal penetration, lower uterine segment involvement, or capillary space involvement. Seventy-two percent of the patients had multiple high-risk factors. An average of 4700 cGy of whole-pelvis radiotherapy was administered. Ten percent of the patients suffered major gastrointestinal complications, 14% minor gastrointestinal morbidity, 12% minor genitourinary complications, one patient a lymphocyst, and one patient lymphed-ema. Of the five patients with major gastrointestinal morbidity, all occurred within 12 months of treatment. Three patients required intestinal bypass surgery for distal ileal obstructions and all are currently doing well and free of disease. All of the patients who developed recurrent disease had multiple, high-risk factors. The median time of recurrence was 12 months. All patients recurred within the radiated field. Actuarial survival was 90% and disease-free survival 87% at 70 months. It is our opinion that the morbidity of postoperative pelvic radiotherapy is acceptable, and benefit may be gained in such a high-risk patient population.</abstract><qualityIndicators><score>4.604</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 756 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1460</abstractCharCount><pdfWordCount>2156</pdfWordCount><pdfCharCount>14720</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>204</abstractWordCount></qualityIndicators><title>Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy</title><pii><json:string>0090-8258(90)90139-C</json:string></pii><genre><json:string>research-article</json:string></genre><serie><title>A report from the Presidential Panel at the 1979 annual meeting of the Society of Gynecologic Oncol-ogists</title><language><json:string>unknown</json:string></language><pages><first>105</first><last>110</last></pages></serie><host><title>Gynecologic Oncology</title><language><json:string>unknown</json:string></language><publicationDate>1990</publicationDate><issn><json:string>0090-8258</json:string></issn><pii><json:string>S0090-8258(00)X0139-4</json:string></pii><volume>36</volume><issue>3</issue><pages><first>343</first><last>347</last></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>oncology</json:string><json:string>obstetrics & gynecology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>oncology & carcinogenesis</json:string></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string></inist></categories><publicationDate>1990</publicationDate><copyrightDate>1990</copyrightDate><doi><json:string>10.1016/0090-8258(90)90139-C</json:string></doi><id>853C5D1007E2A2DA5E3CD9DE932605DFCCC5888C</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/853C5D1007E2A2DA5E3CD9DE932605DFCCC5888C/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/853C5D1007E2A2DA5E3CD9DE932605DFCCC5888C/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/853C5D1007E2A2DA5E3CD9DE932605DFCCC5888C/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>1990</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy</title><author xml:id="author-0000"><persName><forename type="first">James V.</forename><surname>Fiorica</surname></persName><roleName type="degree">M.D.</roleName><affiliation>To whom correspondence and reprint requests should be addressed at Division of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, 12902 Mag-nolia Drive, Tampa, FL 33612.</affiliation><affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USADivision of Radiation Oncology, Department of Radiology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation></author><author xml:id="author-0001"><persName><forename type="first">William S.</forename><surname>Roberts</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Harvey</forename><surname>Greenberg</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Radiation Oncology, Department of Radiology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Mitchel S.</forename><surname>Hoffman</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation></author><author xml:id="author-0004"><persName><forename type="first">James P.</forename><surname>LaPolla</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Denis</forename><surname>Cavanagh</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation></author><idno type="istex">853C5D1007E2A2DA5E3CD9DE932605DFCCC5888C</idno><idno type="DOI">10.1016/0090-8258(90)90139-C</idno><idno type="PII">0090-8258(90)90139-C</idno></analytic><monogr><title level="j">Gynecologic Oncology</title><title level="j" type="abbrev">YGYNO</title><idno type="pISSN">0090-8258</idno><idno type="PII">S0090-8258(00)X0139-4</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1990"></date><biblScope unit="volume">36</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="343">343</biblScope><biblScope unit="page" to="347">347</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1990</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Morbidity and survival patterns were reviewed in 50 patients who underwent radical hysterectomy, pelvic lymphadenectomy, and adjuvant postoperative pelvic radiotherapy for invasive cervical cancer. Ninety percent of the patients were FIGO stage IB, and 10% were clinical stage IIA or IIB. Indications for adjuvant radiotherapy included pelvic lymph node metastasis, large volume, deep stromal penetration, lower uterine segment involvement, or capillary space involvement. Seventy-two percent of the patients had multiple high-risk factors. An average of 4700 cGy of whole-pelvis radiotherapy was administered. Ten percent of the patients suffered major gastrointestinal complications, 14% minor gastrointestinal morbidity, 12% minor genitourinary complications, one patient a lymphocyst, and one patient lymphed-ema. Of the five patients with major gastrointestinal morbidity, all occurred within 12 months of treatment. Three patients required intestinal bypass surgery for distal ileal obstructions and all are currently doing well and free of disease. All of the patients who developed recurrent disease had multiple, high-risk factors. The median time of recurrence was 12 months. All patients recurred within the radiated field. Actuarial survival was 90% and disease-free survival 87% at 70 months. It is our opinion that the morbidity of postoperative pelvic radiotherapy is acceptable, and benefit may be gained in such a high-risk patient population.</p></abstract></profileDesc><revisionDesc><change when="1990">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/853C5D1007E2A2DA5E3CD9DE932605DFCCC5888C/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla"><item-info><jid>YGYNO</jid><aid>9090139C</aid><ce:pii>0090-8258(90)90139-C</ce:pii><ce:doi>10.1016/0090-8258(90)90139-C</ce:doi><ce:copyright type="unknown" year="1990"></ce:copyright></item-info><head><ce:title>Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy</ce:title><ce:author-group><ce:author><ce:given-name>James V.</ce:given-name><ce:surname>Fiorica</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="COR1"><ce:sup>1</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>William S.</ce:given-name><ce:surname>Roberts</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Harvey</ce:given-name><ce:surname>Greenberg</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF2"><ce:sup>b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Mitchel S.</ce:given-name><ce:surname>Hoffman</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>James P.</ce:given-name><ce:surname>LaPolla</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Denis</ce:given-name><ce:surname>Cavanagh</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup>a</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>a</ce:label><ce:textfn>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>b</ce:label><ce:textfn>Division of Radiation Oncology, Department of Radiology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>1</ce:label><ce:text>To whom correspondence and reprint requests should be addressed at Division of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, 12902 Mag-nolia Drive, Tampa, FL 33612.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="21" month="4" year="1989"></ce:date-received><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>Morbidity and survival patterns were reviewed in 50 patients who underwent radical hysterectomy, pelvic lymphadenectomy, and adjuvant postoperative pelvic radiotherapy for invasive cervical cancer. Ninety percent of the patients were FIGO stage IB, and 10% were clinical stage IIA or IIB. Indications for adjuvant radiotherapy included pelvic lymph node metastasis, large volume, deep stromal penetration, lower uterine segment involvement, or capillary space involvement. Seventy-two percent of the patients had multiple high-risk factors. An average of 4700 cGy of whole-pelvis radiotherapy was administered. Ten percent of the patients suffered major gastrointestinal complications, 14% minor gastrointestinal morbidity, 12% minor genitourinary complications, one patient a lymphocyst, and one patient lymphed-ema. Of the five patients with major gastrointestinal morbidity, all occurred within 12 months of treatment. Three patients required intestinal bypass surgery for distal ileal obstructions and all are currently doing well and free of disease. All of the patients who developed recurrent disease had multiple, high-risk factors. The median time of recurrence was 12 months. All patients recurred within the radiated field. Actuarial survival was 90% and disease-free survival 87% at 70 months. It is our opinion that the morbidity of postoperative pelvic radiotherapy is acceptable, and benefit may be gained in such a high-risk patient population.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy</title></titleInfo><name type="personal"><namePart type="given">James V.</namePart><namePart type="family">Fiorica</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USADivision of Radiation Oncology, Department of Radiology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation><description>To whom correspondence and reprint requests should be addressed at Division of Gynecologic Oncology, H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, 12902 Mag-nolia Drive, Tampa, FL 33612.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">William S.</namePart><namePart type="family">Roberts</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Harvey</namePart><namePart type="family">Greenberg</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Radiation Oncology, Department of Radiology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mitchel S.</namePart><namePart type="family">Hoffman</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">James P.</namePart><namePart type="family">LaPolla</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Denis</namePart><namePart type="family">Cavanagh</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa, Florida 33612 USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1990</dateIssued><copyrightDate encoding="w3cdtf">1990</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Morbidity and survival patterns were reviewed in 50 patients who underwent radical hysterectomy, pelvic lymphadenectomy, and adjuvant postoperative pelvic radiotherapy for invasive cervical cancer. Ninety percent of the patients were FIGO stage IB, and 10% were clinical stage IIA or IIB. Indications for adjuvant radiotherapy included pelvic lymph node metastasis, large volume, deep stromal penetration, lower uterine segment involvement, or capillary space involvement. Seventy-two percent of the patients had multiple high-risk factors. An average of 4700 cGy of whole-pelvis radiotherapy was administered. Ten percent of the patients suffered major gastrointestinal complications, 14% minor gastrointestinal morbidity, 12% minor genitourinary complications, one patient a lymphocyst, and one patient lymphed-ema. Of the five patients with major gastrointestinal morbidity, all occurred within 12 months of treatment. Three patients required intestinal bypass surgery for distal ileal obstructions and all are currently doing well and free of disease. All of the patients who developed recurrent disease had multiple, high-risk factors. The median time of recurrence was 12 months. All patients recurred within the radiated field. Actuarial survival was 90% and disease-free survival 87% at 70 months. It is our opinion that the morbidity of postoperative pelvic radiotherapy is acceptable, and benefit may be gained in such a high-risk patient population.</abstract><relatedItem type="host"><titleInfo><title>Gynecologic Oncology</title></titleInfo><titleInfo type="abbreviated"><title>YGYNO</title></titleInfo><genre type="journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">199003</dateIssued></originInfo><identifier type="ISSN">0090-8258</identifier><identifier type="PII">S0090-8258(00)X0139-4</identifier><part><date>199003</date><detail type="volume"><number>36</number><caption>vol.</caption></detail><detail type="issue"><number>3</number><caption>no.</caption></detail><extent unit="issue pages"><start>299</start><end>447</end></extent><extent unit="pages"><start>343</start><end>347</end></extent></part></relatedItem><identifier type="istex">853C5D1007E2A2DA5E3CD9DE932605DFCCC5888C</identifier><identifier type="DOI">10.1016/0090-8258(90)90139-C</identifier><identifier type="PII">0090-8258(90)90139-C</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata></istex></record>Pour manipuler ce document sous Unix (Dilib)
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