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
Links to Exploration step
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<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>
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<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>
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<ce:author><ce:given-name>William S.</ce:given-name>
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<ce:author><ce:given-name>Denis</ce:given-name>
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<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>
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<mods version="3.6"><titleInfo><title>Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy</title>
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<titleInfo type="alternative" contentType="CDATA"><title>Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy</title>
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<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>
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<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>
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<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>
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<dateIssued encoding="w3cdtf">1990</dateIssued>
<copyrightDate encoding="w3cdtf">1990</copyrightDate>
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<language><languageTerm type="code" authority="iso639-2b">eng</languageTerm>
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<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>
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<titleInfo type="abbreviated"><title>YGYNO</title>
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<genre type="journal">journal</genre>
<originInfo><dateIssued encoding="w3cdtf">199003</dateIssued>
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<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>
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<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>
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