Analysis of the effect of adjuvant radiotherapy on outcomes and complications after radical hysterectomy in FIGO stage IB1 cervical cancer patients with intermediate risk factors (GOTIC Study)
Identifieur interne : 001424 ( Main/Exploration ); précédent : 001423; suivant : 001425Analysis of the effect of adjuvant radiotherapy on outcomes and complications after radical hysterectomy in FIGO stage IB1 cervical cancer patients with intermediate risk factors (GOTIC Study)
Auteurs : Kazuto Nakamura ; Yoshikazu Kitahara ; Toyomi Satoh ; Yuji Takei ; Masashi Takano ; Shoji Nagao ; Isao Sekiguchi [Japon] ; Mitsuaki SuzukiSource :
- World Journal of Surgical Oncology [ 1477-7819 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Adénocarcinome (), Adénocarcinome (anatomopathologie), Adénocarcinome (radiothérapie), Adénocarcinome (traitement médicamenteux), Carcinome adénosquameux (), Carcinome adénosquameux (anatomopathologie), Carcinome adénosquameux (radiothérapie), Carcinome adénosquameux (traitement médicamenteux), Carcinome épidermoïde (), Carcinome épidermoïde (anatomopathologie), Carcinome épidermoïde (radiothérapie), Carcinome épidermoïde (traitement médicamenteux), Chimioradiothérapie adjuvante, Complications postopératoires (étiologie), Curiethérapie, Facteurs de risque, Femelle, Humains, Hystérectomie, Radiothérapie adjuvante, Résultat thérapeutique, Stade de la tumeur, Sujet âgé, Traitement médicamenteux adjuvant, Tumeurs du col de l'utérus (), Tumeurs du col de l'utérus (anatomopathologie), Tumeurs du col de l'utérus (radiothérapie), Tumeurs du col de l'utérus (traitement médicamenteux), Études de suivi, Études rétrospectives.
- MESH :
- anatomopathologie : Adénocarcinome, Carcinome adénosquameux, Carcinome épidermoïde, Tumeurs du col de l'utérus.
- radiothérapie : Adénocarcinome, Carcinome adénosquameux, Carcinome épidermoïde, Tumeurs du col de l'utérus.
- traitement médicamenteux : Adénocarcinome, Carcinome adénosquameux, Carcinome épidermoïde, Tumeurs du col de l'utérus.
- étiologie : Complications postopératoires.
- Adulte, Adulte d'âge moyen, Adénocarcinome, Carcinome adénosquameux, Carcinome épidermoïde, Chimioradiothérapie adjuvante, Curiethérapie, Facteurs de risque, Femelle, Humains, Hystérectomie, Radiothérapie adjuvante, Résultat thérapeutique, Stade de la tumeur, Sujet âgé, Traitement médicamenteux adjuvant, Tumeurs du col de l'utérus, Études de suivi, Études rétrospectives.
English descriptors
- KwdEn :
- Adenocarcinoma (drug therapy), Adenocarcinoma (pathology), Adenocarcinoma (radiotherapy), Adenocarcinoma (surgery), Adult, Aged, Brachytherapy, Carcinoma, Adenosquamous (drug therapy), Carcinoma, Adenosquamous (pathology), Carcinoma, Adenosquamous (radiotherapy), Carcinoma, Adenosquamous (surgery), Carcinoma, Squamous Cell (drug therapy), Carcinoma, Squamous Cell (pathology), Carcinoma, Squamous Cell (radiotherapy), Carcinoma, Squamous Cell (surgery), Chemoradiotherapy, Adjuvant, Chemotherapy, Adjuvant, Female, Follow-Up Studies, Humans, Hysterectomy, Middle Aged, Neoplasm Staging, Postoperative Complications (etiology), Radiotherapy, Adjuvant, Retrospective Studies, Risk Factors, Treatment Outcome, Uterine Cervical Neoplasms (drug therapy), Uterine Cervical Neoplasms (pathology), Uterine Cervical Neoplasms (radiotherapy), Uterine Cervical Neoplasms (surgery).
- MESH :
- drug therapy : Adenocarcinoma, Carcinoma, Adenosquamous, Carcinoma, Squamous Cell, Uterine Cervical Neoplasms.
- etiology : Postoperative Complications.
- pathology : Adenocarcinoma, Carcinoma, Adenosquamous, Carcinoma, Squamous Cell, Uterine Cervical Neoplasms.
- radiotherapy : Adenocarcinoma, Carcinoma, Adenosquamous, Carcinoma, Squamous Cell, Uterine Cervical Neoplasms.
- surgery : Adenocarcinoma, Carcinoma, Adenosquamous, Carcinoma, Squamous Cell, Uterine Cervical Neoplasms.
- Adult, Aged, Brachytherapy, Chemoradiotherapy, Adjuvant, Chemotherapy, Adjuvant, Female, Follow-Up Studies, Humans, Hysterectomy, Middle Aged, Neoplasm Staging, Radiotherapy, Adjuvant, Retrospective Studies, Risk Factors, Treatment Outcome.
Abstract
There are no definitive criteria for identifying which patients with The International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer will benefit from adjuvant therapy after radical hysterectomy. The aims of this study were to clarify the efficacy of adjuvant therapy and assess complications after radical hysterectomy in patients with FIGO stage IB1 cervical cancer with intermediate risk factors.
Between January 2005 and December 2009, the medical records of 75 stage IB1 patients’ intermediate risk factors (i.e., tumor size 2–4 cm, lymphovascular involvement, and/or deep stromal invasion >1/2) who underwent radical hysterectomy at six institutions were collected, and these patients were enrolled in this nonrandomized retrospective study. We simplified the criteria of intermediate risk factors as much as possible, as the criteria adopted in some clinical studies are complicated in practice.
The patients were grouped according to the receipt of adjuvant therapy as follows: 46 patients, no further treatment; 19 patients, external beam radiation treatment, including 9 patients who received brachytherapy; 5 patients, concurrent chemoradiotherapy (CCRT); and 5 patients, chemotherapy (CT). The clinical outcomes and complications in each group were analyzed. After an average follow-up of 82.6 months (range, 24–135 months), only one patient with all three risk factors who received radiotherapy (RT) experienced recurrence. Excluding this patient, the remaining patients who received RT, CCRT, or CT had two or three risk factors. Lymphedema was significantly more common among patients who received RT or CCRT, whereas the incidence of ileus and ureteral obstruction was not different among the treatment groups. However, an unsutured peritoneum increased the risk of ileus.
The findings of this study suggest that RT and CCRT after radical hysterectomy are not beneficial in patients with intermediate risk factors. In particular, RT and CCRT appeared to increase the incidence of lymphedema. A prospective randomized study is needed to verify the findings of this study.
Url:
DOI: 10.1186/s12957-016-0931-4
PubMed: 27356862
PubMed Central: 4928324
Affiliations:
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371-8511 Japan</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff7">Current address: Department of Gynecology, Gunma Cancer Center, Ota, Gunma 373-8550 Japan</nlm:aff><wicri:noCountry code="subfield">Gunma 373-8550 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Kitahara, Yoshikazu" sort="Kitahara, Yoshikazu" uniqKey="Kitahara Y" first="Yoshikazu" last="Kitahara">Yoshikazu Kitahara</name><affiliation><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Gunma University Hospital, Maebashi, Gunma 371-8511 Japan</nlm:aff><wicri:noCountry code="subfield">Gunma 371-8511 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Satoh, Toyomi" sort="Satoh, Toyomi" uniqKey="Satoh T" first="Toyomi" last="Satoh">Toyomi Satoh</name><affiliation><nlm:aff id="Aff2">Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8577 Japan</nlm:aff><wicri:noCountry code="subfield">Ibaraki 305-8577 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Takei, Yuji" sort="Takei, Yuji" uniqKey="Takei Y" first="Yuji" last="Takei">Yuji Takei</name><affiliation><nlm:aff id="Aff3">Department of Obstetrics and Gynecology, Jichi Medical University Hospital, Shimotsuke, Tochigi 329-0498 Japan</nlm:aff><wicri:noCountry code="subfield">Tochigi 329-0498 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Takano, Masashi" sort="Takano, Masashi" uniqKey="Takano M" first="Masashi" last="Takano">Masashi Takano</name><affiliation><nlm:aff id="Aff4">Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Saitama 359-8513 Japan</nlm:aff><wicri:noCountry code="subfield">Saitama 359-8513 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Nagao, Shoji" sort="Nagao, Shoji" uniqKey="Nagao S" first="Shoji" last="Nagao">Shoji Nagao</name><affiliation><nlm:aff id="Aff5">Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298 Japan</nlm:aff><wicri:noCountry code="subfield">Saitama 350-1298 Japan</wicri:noCountry></affiliation><affiliation><nlm:aff id="Aff8">Current address: Department of Gynecology, Hyogo Cancer Center, Akashi, Hyogo 673-8558 Japan</nlm:aff><wicri:noCountry code="subfield">Hyogo 673-8558 Japan</wicri:noCountry></affiliation></author><author><name sortKey="Sekiguchi, Isao" sort="Sekiguchi, Isao" uniqKey="Sekiguchi I" first="Isao" last="Sekiguchi">Isao Sekiguchi</name><affiliation wicri:level="1"><nlm:aff id="Aff6">Department of Gynecology, Tochigi Cancer Center, Utusnomiya, Tochigi, 320-0834 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Gynecology, Tochigi Cancer Center, Utusnomiya, Tochigi</wicri:regionArea><wicri:noRegion>Tochigi</wicri:noRegion></affiliation></author><author><name sortKey="Suzuki, Mitsuaki" sort="Suzuki, Mitsuaki" uniqKey="Suzuki M" first="Mitsuaki" last="Suzuki">Mitsuaki Suzuki</name><affiliation><nlm:aff id="Aff3">Department of Obstetrics and Gynecology, Jichi Medical University Hospital, Shimotsuke, Tochigi 329-0498 Japan</nlm:aff><wicri:noCountry code="subfield">Tochigi 329-0498 Japan</wicri:noCountry></affiliation></author></analytic><series><title level="j">World Journal of Surgical Oncology</title><idno type="eISSN">1477-7819</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adenocarcinoma (drug therapy)</term><term>Adenocarcinoma (pathology)</term><term>Adenocarcinoma (radiotherapy)</term><term>Adenocarcinoma (surgery)</term><term>Adult</term><term>Aged</term><term>Brachytherapy</term><term>Carcinoma, Adenosquamous (drug therapy)</term><term>Carcinoma, Adenosquamous (pathology)</term><term>Carcinoma, Adenosquamous (radiotherapy)</term><term>Carcinoma, Adenosquamous (surgery)</term><term>Carcinoma, Squamous Cell (drug therapy)</term><term>Carcinoma, Squamous Cell (pathology)</term><term>Carcinoma, Squamous Cell (radiotherapy)</term><term>Carcinoma, Squamous Cell (surgery)</term><term>Chemoradiotherapy, Adjuvant</term><term>Chemotherapy, Adjuvant</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Hysterectomy</term><term>Middle Aged</term><term>Neoplasm Staging</term><term>Postoperative Complications (etiology)</term><term>Radiotherapy, Adjuvant</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Treatment Outcome</term><term>Uterine Cervical Neoplasms (drug therapy)</term><term>Uterine Cervical Neoplasms (pathology)</term><term>Uterine Cervical Neoplasms (radiotherapy)</term><term>Uterine Cervical Neoplasms (surgery)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Adénocarcinome ()</term><term>Adénocarcinome (anatomopathologie)</term><term>Adénocarcinome (radiothérapie)</term><term>Adénocarcinome (traitement médicamenteux)</term><term>Carcinome adénosquameux ()</term><term>Carcinome adénosquameux (anatomopathologie)</term><term>Carcinome adénosquameux (radiothérapie)</term><term>Carcinome adénosquameux (traitement médicamenteux)</term><term>Carcinome épidermoïde ()</term><term>Carcinome épidermoïde (anatomopathologie)</term><term>Carcinome épidermoïde (radiothérapie)</term><term>Carcinome épidermoïde (traitement médicamenteux)</term><term>Chimioradiothérapie adjuvante</term><term>Complications postopératoires (étiologie)</term><term>Curiethérapie</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Hystérectomie</term><term>Radiothérapie adjuvante</term><term>Résultat thérapeutique</term><term>Stade de la tumeur</term><term>Sujet âgé</term><term>Traitement médicamenteux adjuvant</term><term>Tumeurs du col de l'utérus ()</term><term>Tumeurs du col de l'utérus (anatomopathologie)</term><term>Tumeurs du col de l'utérus (radiothérapie)</term><term>Tumeurs du col de l'utérus (traitement médicamenteux)</term><term>Études de suivi</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Adénocarcinome</term><term>Carcinome adénosquameux</term><term>Carcinome épidermoïde</term><term>Tumeurs du col de l'utérus</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Adenocarcinoma</term><term>Carcinoma, Adenosquamous</term><term>Carcinoma, Squamous Cell</term><term>Uterine Cervical Neoplasms</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Adenocarcinoma</term><term>Carcinoma, Adenosquamous</term><term>Carcinoma, Squamous Cell</term><term>Uterine Cervical Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Adenocarcinoma</term><term>Carcinoma, Adenosquamous</term><term>Carcinoma, Squamous Cell</term><term>Uterine Cervical Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Adénocarcinome</term><term>Carcinome adénosquameux</term><term>Carcinome épidermoïde</term><term>Tumeurs du col de l'utérus</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Adenocarcinoma</term><term>Carcinoma, Adenosquamous</term><term>Carcinoma, Squamous Cell</term><term>Uterine Cervical Neoplasms</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Adénocarcinome</term><term>Carcinome adénosquameux</term><term>Carcinome épidermoïde</term><term>Tumeurs du col de l'utérus</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Complications postopératoires</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Brachytherapy</term><term>Chemoradiotherapy, Adjuvant</term><term>Chemotherapy, Adjuvant</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Hysterectomy</term><term>Middle Aged</term><term>Neoplasm Staging</term><term>Radiotherapy, Adjuvant</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Adénocarcinome</term><term>Carcinome adénosquameux</term><term>Carcinome épidermoïde</term><term>Chimioradiothérapie adjuvante</term><term>Curiethérapie</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Hystérectomie</term><term>Radiothérapie adjuvante</term><term>Résultat thérapeutique</term><term>Stade de la tumeur</term><term>Sujet âgé</term><term>Traitement médicamenteux adjuvant</term><term>Tumeurs du col de l'utérus</term><term>Études de suivi</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>There are no definitive criteria for identifying which patients with The International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer will benefit from adjuvant therapy after radical hysterectomy. The aims of this study were to clarify the efficacy of adjuvant therapy and assess complications after radical hysterectomy in patients with FIGO stage IB1 cervical cancer with intermediate risk factors.</p></sec><sec><title>Methods</title><p>Between January 2005 and December 2009, the medical records of 75 stage IB1 patients’ intermediate risk factors (i.e., tumor size 2–4 cm, lymphovascular involvement, and/or deep stromal invasion >1/2) who underwent radical hysterectomy at six institutions were collected, and these patients were enrolled in this nonrandomized retrospective study. We simplified the criteria of intermediate risk factors as much as possible, as the criteria adopted in some clinical studies are complicated in practice.</p></sec><sec><title>Results</title><p>The patients were grouped according to the receipt of adjuvant therapy as follows: 46 patients, no further treatment; 19 patients, external beam radiation treatment, including 9 patients who received brachytherapy; 5 patients, concurrent chemoradiotherapy (CCRT); and 5 patients, chemotherapy (CT). The clinical outcomes and complications in each group were analyzed. After an average follow-up of 82.6 months (range, 24–135 months), only one patient with all three risk factors who received radiotherapy (RT) experienced recurrence. Excluding this patient, the remaining patients who received RT, CCRT, or CT had two or three risk factors. Lymphedema was significantly more common among patients who received RT or CCRT, whereas the incidence of ileus and ureteral obstruction was not different among the treatment groups. However, an unsutured peritoneum increased the risk of ileus.</p></sec><sec><title>Conclusions</title><p>The findings of this study suggest that RT and CCRT after radical hysterectomy are not beneficial in patients with intermediate risk factors. In particular, RT and CCRT appeared to increase the incidence of lymphedema. A prospective randomized study is needed to verify the findings of this study.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Bermudez, A" uniqKey="Bermudez A">A Bermudez</name></author><author><name sortKey="Bhatla, N" uniqKey="Bhatla N">N Bhatla</name></author><author><name sortKey="Leung, E" uniqKey="Leung E">E Leung</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gray, Hj" uniqKey="Gray H">HJ Gray</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Landoni, F" uniqKey="Landoni F">F Landoni</name></author><author><name sortKey="Maneo, A" uniqKey="Maneo A">A Maneo</name></author><author><name sortKey="Colombo, A" uniqKey="Colombo A">A Colombo</name></author><author><name sortKey="Placa, F" uniqKey="Placa F">F Placa</name></author><author><name sortKey="Milani, R" uniqKey="Milani R">R Milani</name></author><author><name sortKey="Perego, P" uniqKey="Perego P">P Perego</name></author><author><name sortKey="Favini, G" uniqKey="Favini G">G Favini</name></author><author><name sortKey="Ferri, L" uniqKey="Ferri L">L Ferri</name></author><author><name sortKey="Mangioni, C" uniqKey="Mangioni C">C Mangioni</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Peters, Wa" uniqKey="Peters W">WA Peters</name></author><author><name sortKey="Liu, Py" uniqKey="Liu P">PY Liu</name></author><author><name sortKey="Barrett, Rj" uniqKey="Barrett R">RJ Barrett</name></author><author><name sortKey="Stock, Rj" uniqKey="Stock R">RJ Stock</name></author><author><name sortKey="Monk, Bj" uniqKey="Monk B">BJ Monk</name></author><author><name sortKey="Berek, Js" uniqKey="Berek J">JS Berek</name></author><author><name sortKey="Souhami, L" uniqKey="Souhami L">L Souhami</name></author><author><name sortKey="Grigsby, P" uniqKey="Grigsby P">P Grigsby</name></author><author><name sortKey="Gordon, W" uniqKey="Gordon W">W 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Battistutta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Le Borgne, G" uniqKey="Le Borgne G">G Le Borgne</name></author><author><name sortKey="Mercier, M" uniqKey="Mercier M">M Mercier</name></author><author><name sortKey="Woronoff, As" uniqKey="Woronoff A">AS Woronoff</name></author><author><name sortKey="Guizard, Av" uniqKey="Guizard A">AV Guizard</name></author><author><name sortKey="Abeilard, E" uniqKey="Abeilard E">E Abeilard</name></author><author><name sortKey="Caravati Jouvenceaux, A" uniqKey="Caravati Jouvenceaux A">A Caravati-Jouvenceaux</name></author><author><name sortKey="Klein, D" uniqKey="Klein D">D Klein</name></author><author><name sortKey="Velten, M" uniqKey="Velten M">M Velten</name></author><author><name sortKey="Joly, F" uniqKey="Joly F">F Joly</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Japon</li></country></list><tree><noCountry><name sortKey="Kitahara, Yoshikazu" sort="Kitahara, Yoshikazu" uniqKey="Kitahara Y" first="Yoshikazu" last="Kitahara">Yoshikazu Kitahara</name><name sortKey="Nagao, Shoji" sort="Nagao, Shoji" uniqKey="Nagao S" first="Shoji" last="Nagao">Shoji Nagao</name><name sortKey="Nakamura, Kazuto" sort="Nakamura, Kazuto" uniqKey="Nakamura K" first="Kazuto" last="Nakamura">Kazuto Nakamura</name><name sortKey="Satoh, Toyomi" sort="Satoh, Toyomi" uniqKey="Satoh T" first="Toyomi" last="Satoh">Toyomi Satoh</name><name sortKey="Suzuki, Mitsuaki" sort="Suzuki, Mitsuaki" uniqKey="Suzuki M" first="Mitsuaki" last="Suzuki">Mitsuaki Suzuki</name><name sortKey="Takano, Masashi" sort="Takano, Masashi" uniqKey="Takano M" first="Masashi" last="Takano">Masashi Takano</name><name sortKey="Takei, Yuji" sort="Takei, Yuji" uniqKey="Takei Y" first="Yuji" last="Takei">Yuji Takei</name></noCountry><country name="Japon"><noRegion><name sortKey="Sekiguchi, Isao" sort="Sekiguchi, Isao" uniqKey="Sekiguchi I" first="Isao" last="Sekiguchi">Isao 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