Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer
Identifieur interne : 002609 ( Main/Exploration ); précédent : 002608; suivant : 002610Radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer
Auteurs : Yanlan Chai [République populaire de Chine] ; Tao Wang [République populaire de Chine] ; Juan Wang [République populaire de Chine] ; Yunyi Yang [République populaire de Chine] ; Ying Gao [République populaire de Chine] ; Jiyong Gao [République populaire de Chine] ; Shangfeng Gao [République populaire de Chine] ; Yueling Wang [République populaire de Chine] ; Xi Zhou [République populaire de Chine] ; Zi Liu [République populaire de Chine]Source :
- BMC Cancer [ 1471-2407 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Analyse multivariée, Charge tumorale, Estimation de Kaplan-Meier, Facteurs de risque, Facteurs temps, Femelle, Humains, Hystérectomie (effets indésirables), Hystérectomie (mortalité), Jeune adulte, Loi du khi-deux, Lymphadénectomie, Modèles de hasards proportionnels, Radiothérapie adjuvante, Récidive tumorale locale, Résultat thérapeutique, Stade de la tumeur, Sujet âgé, Sujet âgé de 80 ans ou plus, Survie sans rechute, Tumeurs du col de l'utérus (), Tumeurs du col de l'utérus (anatomopathologie), Tumeurs du col de l'utérus (mortalité), Tumeurs du col de l'utérus (radiothérapie), Études rétrospectives.
- MESH :
- anatomopathologie : Tumeurs du col de l'utérus.
- effets indésirables : Hystérectomie.
- mortalité : Hystérectomie, Tumeurs du col de l'utérus.
- radiothérapie : Tumeurs du col de l'utérus.
- Adulte, Adulte d'âge moyen, Analyse multivariée, Charge tumorale, Estimation de Kaplan-Meier, Facteurs de risque, Facteurs temps, Femelle, Humains, Jeune adulte, Loi du khi-deux, Lymphadénectomie, Modèles de hasards proportionnels, Radiothérapie adjuvante, Récidive tumorale locale, Résultat thérapeutique, Stade de la tumeur, Sujet âgé, Sujet âgé de 80 ans ou plus, Survie sans rechute, Tumeurs du col de l'utérus, Études rétrospectives.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Disease-Free Survival, Female, Humans, Hysterectomy (adverse effects), Hysterectomy (mortality), Kaplan-Meier Estimate, Lymph Node Excision, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local, Neoplasm Staging, Proportional Hazards Models, Radiotherapy, Adjuvant, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Tumor Burden, Uterine Cervical Neoplasms (mortality), Uterine Cervical Neoplasms (pathology), Uterine Cervical Neoplasms (radiotherapy), Uterine Cervical Neoplasms (surgery), Young Adult.
- MESH :
- adverse effects : Hysterectomy.
- mortality : Hysterectomy, Uterine Cervical Neoplasms.
- pathology : Uterine Cervical Neoplasms.
- radiotherapy : Uterine Cervical Neoplasms.
- surgery : Uterine Cervical Neoplasms.
- Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Disease-Free Survival, Female, Humans, Kaplan-Meier Estimate, Lymph Node Excision, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local, Neoplasm Staging, Proportional Hazards Models, Radiotherapy, Adjuvant, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Tumor Burden, Young Adult.
Abstract
The goal of this study was to compare treatment outcomes for Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma patients receiving radical surgery followed by adjuvant postoperative radiotherapy versus radical radiotherapy.
Medical records of FIGO stage IIB cervical cancer patients treated between July 2008 and December 2011 were retrospectively reviewed. A total of 148 patients underwent radical hysterectomy with pelvic lymph node dissection followed by adjuvant radiotherapy (surgery-based group). These patients were compared with 290 patients that received radical radiotherapy alone (RT-based group). Recurrence rates, progression-free survival (PFS), overall survival (OS), local control rates, and treatment-related complications were compared for these two groups.
Similar rates of recurrence (16.89% vs. 12.41%, p = 0.200), PFS (log-rank, p = 0.211), OS (log-rank, p = 0.347), and local control rates (log-rank, p = 0.668) were observed for the surgery-based group and the RT-based group, respectively. Moreover, the incidence of acute grade 3–4 gastrointestinal reactions and late grade 3–4 lower limb lymphedema were significantly higher for the surgery-based group versus the RT-based group. Cox multivariate analyses found no significant difference in survival outcome between the two groups, and tumor diameter and histopathology were identified as significant prognostic factors for OS.
Radical radiotherapy was associated with fewer treatment-related complications and achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer compared to radical hysterectomy followed by postoperative radiotherapy.
Url:
DOI: 10.1186/1471-2407-14-63
PubMed: 24495453
PubMed Central: 3918172
Affiliations:
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Yanlan" uniqKey="Chai Y" first="Yanlan" last="Chai">Yanlan Chai</name><affiliation wicri:level="1"><nlm:aff id="I1">The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061</wicri:regionArea><wicri:noRegion>Xi’an 710061</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Tao" sort="Wang, Tao" uniqKey="Wang T" first="Tao" last="Wang">Tao Wang</name><affiliation wicri:level="1"><nlm:aff id="I1">The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061</wicri:regionArea><wicri:noRegion>Xi’an 710061</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Juan" sort="Wang, Juan" uniqKey="Wang J" first="Juan" last="Wang">Juan Wang</name><affiliation wicri:level="1"><nlm:aff id="I1">The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061</wicri:regionArea><wicri:noRegion>Xi’an 710061</wicri:noRegion></affiliation></author><author><name sortKey="Yang, Yunyi" sort="Yang, Yunyi" uniqKey="Yang Y" first="Yunyi" last="Yang">Yunyi Yang</name><affiliation wicri:level="1"><nlm:aff id="I1">The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061</wicri:regionArea><wicri:noRegion>Xi’an 710061</wicri:noRegion></affiliation></author><author><name sortKey="Gao, Ying" sort="Gao, Ying" uniqKey="Gao Y" first="Ying" last="Gao">Ying Gao</name><affiliation wicri:level="1"><nlm:aff id="I1">The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061</wicri:regionArea><wicri:noRegion>Xi’an 710061</wicri:noRegion></affiliation></author><author><name sortKey="Gao, Jiyong" sort="Gao, Jiyong" uniqKey="Gao J" first="Jiyong" last="Gao">Jiyong Gao</name><affiliation wicri:level="1"><nlm:aff id="I2">The Department of Gynecology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Department of Gynecology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061</wicri:regionArea><wicri:noRegion>Xi’an 710061</wicri:noRegion></affiliation></author><author><name sortKey="Gao, Shangfeng" sort="Gao, Shangfeng" uniqKey="Gao S" first="Shangfeng" last="Gao">Shangfeng Gao</name><affiliation wicri:level="1"><nlm:aff id="I2">The Department of Gynecology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Department of Gynecology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061</wicri:regionArea><wicri:noRegion>Xi’an 710061</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Yueling" sort="Wang, Yueling" uniqKey="Wang Y" first="Yueling" last="Wang">Yueling Wang</name><affiliation wicri:level="1"><nlm:aff id="I2">The Department of Gynecology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Department of Gynecology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061</wicri:regionArea><wicri:noRegion>Xi’an 710061</wicri:noRegion></affiliation></author><author><name sortKey="Zhou, Xi" sort="Zhou, Xi" uniqKey="Zhou X" first="Xi" last="Zhou">Xi Zhou</name><affiliation wicri:level="1"><nlm:aff id="I1">The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061</wicri:regionArea><wicri:noRegion>Xi’an 710061</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei 442000</wicri:regionArea><wicri:noRegion>Hubei 442000</wicri:noRegion></affiliation></author><author><name sortKey="Liu, Zi" sort="Liu, Zi" uniqKey="Liu Z" first="Zi" last="Liu">Zi Liu</name><affiliation wicri:level="1"><nlm:aff id="I1">The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>The Department of Radiotherapy Oncology of the 1st Affiliated Hospital, Xi’an Jiao Tong University, Xi’an 710061</wicri:regionArea><wicri:noRegion>Xi’an 710061</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Cancer</title><idno type="eISSN">1471-2407</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Chi-Square Distribution</term><term>Disease-Free Survival</term><term>Female</term><term>Humans</term><term>Hysterectomy (adverse effects)</term><term>Hysterectomy (mortality)</term><term>Kaplan-Meier Estimate</term><term>Lymph Node Excision</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Neoplasm Recurrence, Local</term><term>Neoplasm Staging</term><term>Proportional Hazards Models</term><term>Radiotherapy, Adjuvant</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Time Factors</term><term>Treatment Outcome</term><term>Tumor Burden</term><term>Uterine Cervical Neoplasms (mortality)</term><term>Uterine Cervical Neoplasms (pathology)</term><term>Uterine Cervical Neoplasms (radiotherapy)</term><term>Uterine Cervical Neoplasms (surgery)</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse multivariée</term><term>Charge tumorale</term><term>Estimation de Kaplan-Meier</term><term>Facteurs de risque</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Hystérectomie (effets indésirables)</term><term>Hystérectomie (mortalité)</term><term>Jeune adulte</term><term>Loi du khi-deux</term><term>Lymphadénectomie</term><term>Modèles de hasards proportionnels</term><term>Radiothérapie adjuvante</term><term>Récidive tumorale locale</term><term>Résultat thérapeutique</term><term>Stade de la tumeur</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Survie sans rechute</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 (mortalité)</term><term>Tumeurs du col de l'utérus (radiothérapie)</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Hysterectomy</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs du col de l'utérus</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Hystérectomie</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Hysterectomy</term><term>Uterine Cervical Neoplasms</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Hystérectomie</term><term>Tumeurs du col de l'utérus</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Uterine Cervical Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Uterine Cervical Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Tumeurs du col de l'utérus</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Uterine Cervical Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Chi-Square Distribution</term><term>Disease-Free Survival</term><term>Female</term><term>Humans</term><term>Kaplan-Meier Estimate</term><term>Lymph Node Excision</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Neoplasm Recurrence, Local</term><term>Neoplasm Staging</term><term>Proportional Hazards Models</term><term>Radiotherapy, Adjuvant</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Time Factors</term><term>Treatment Outcome</term><term>Tumor Burden</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse multivariée</term><term>Charge tumorale</term><term>Estimation de Kaplan-Meier</term><term>Facteurs de risque</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Loi du khi-deux</term><term>Lymphadénectomie</term><term>Modèles de hasards proportionnels</term><term>Radiothérapie adjuvante</term><term>Récidive tumorale locale</term><term>Résultat thérapeutique</term><term>Stade de la tumeur</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Survie sans rechute</term><term>Tumeurs du col de l'utérus</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The goal of this study was to compare treatment outcomes for Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical carcinoma patients receiving radical surgery followed by adjuvant postoperative radiotherapy versus radical radiotherapy.</p></sec><sec><title>Methods</title><p>Medical records of FIGO stage IIB cervical cancer patients treated between July 2008 and December 2011 were retrospectively reviewed. A total of 148 patients underwent radical hysterectomy with pelvic lymph node dissection followed by adjuvant radiotherapy (surgery-based group). These patients were compared with 290 patients that received radical radiotherapy alone (RT-based group). Recurrence rates, progression-free survival (PFS), overall survival (OS), local control rates, and treatment-related complications were compared for these two groups.</p></sec><sec><title>Results</title><p>Similar rates of recurrence (16.89% vs. 12.41%, p = 0.200), PFS (log-rank, p = 0.211), OS (log-rank, p = 0.347), and local control rates (log-rank, p = 0.668) were observed for the surgery-based group and the RT-based group, respectively. Moreover, the incidence of acute grade 3–4 gastrointestinal reactions and late grade 3–4 lower limb lymphedema were significantly higher for the surgery-based group versus the RT-based group. Cox multivariate analyses found no significant difference in survival outcome between the two groups, and tumor diameter and histopathology were identified as significant prognostic factors for OS.</p></sec><sec><title>Conclusions</title><p>Radical radiotherapy was associated with fewer treatment-related complications and achieved comparable survival outcomes for patients with FIGO stage IIB cervical cancer compared to radical hysterectomy followed by postoperative radiotherapy.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Kasamatsu, T" uniqKey="Kasamatsu T">T Kasamatsu</name></author><author><name sortKey="Onda, T" uniqKey="Onda T">T Onda</name></author><author><name sortKey="Sawada, M" uniqKey="Sawada M">M Sawada</name></author><author><name sortKey="Kato, T" uniqKey="Kato T">T Kato</name></author><author><name sortKey="Ikeda, S" uniqKey="Ikeda S">S 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first="Jiyong" last="Gao">Jiyong Gao</name><name sortKey="Gao, Shangfeng" sort="Gao, Shangfeng" uniqKey="Gao S" first="Shangfeng" last="Gao">Shangfeng Gao</name><name sortKey="Gao, Ying" sort="Gao, Ying" uniqKey="Gao Y" first="Ying" last="Gao">Ying Gao</name><name sortKey="Liu, Zi" sort="Liu, Zi" uniqKey="Liu Z" first="Zi" last="Liu">Zi Liu</name><name sortKey="Wang, Juan" sort="Wang, Juan" uniqKey="Wang J" first="Juan" last="Wang">Juan Wang</name><name sortKey="Wang, Tao" sort="Wang, Tao" uniqKey="Wang T" first="Tao" last="Wang">Tao Wang</name><name sortKey="Wang, Yueling" sort="Wang, Yueling" uniqKey="Wang Y" first="Yueling" last="Wang">Yueling Wang</name><name sortKey="Yang, Yunyi" sort="Yang, Yunyi" uniqKey="Yang Y" first="Yunyi" last="Yang">Yunyi Yang</name><name sortKey="Zhou, Xi" sort="Zhou, Xi" uniqKey="Zhou X" first="Xi" last="Zhou">Xi Zhou</name><name sortKey="Zhou, Xi" sort="Zhou, Xi" uniqKey="Zhou X" first="Xi" last="Zhou">Xi 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