Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer
Identifieur interne : 00DB52 ( Main/Exploration ); précédent : 00DB51; suivant : 00DB53Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer
Auteurs : Andrew P. Soisson [États-Unis] ; John T. Soper [États-Unis] ; Daniel L. Clarke-Pearson [États-Unis] ; Andrew Berchuck [États-Unis] ; Gustavo Montana [États-Unis] ; William T. Creasman [États-Unis]Source :
- Gynecologic Oncology [ 0090-8258 ] ; 1990.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Analyse de survie, Association thérapeutique, Femelle, Humains, Hystérectomie (), Lymphoedème (étiologie), Lésions radio-induites, Métastase lymphatique, Noeuds lymphatiques (anatomopathologie), Récidive tumorale locale, Sujet âgé, Tumeurs du col de l'utérus (), Tumeurs du col de l'utérus (mortalité), Tumeurs du col de l'utérus (radiothérapie).
- MESH :
- anatomopathologie : Noeuds lymphatiques.
- mortalité : Tumeurs du col de l'utérus.
- radiothérapie : Tumeurs du col de l'utérus.
- étiologie : Lymphoedème.
- Adolescent, Adulte, Adulte d'âge moyen, Analyse de survie, Association thérapeutique, Femelle, Humains, Hystérectomie, Lésions radio-induites, Métastase lymphatique, Récidive tumorale locale, Sujet âgé, Tumeurs du col de l'utérus.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Combined Modality Therapy, Female, Humans, Hysterectomy (methods), Lymph Nodes (pathology), Lymphatic Metastasis, Lymphedema (etiology), Middle Aged, Neoplasm Recurrence, Local, Radiation Injuries, Survival Analysis, Uterine Cervical Neoplasms (mortality), Uterine Cervical Neoplasms (radiotherapy), Uterine Cervical Neoplasms (surgery).
- MESH :
- etiology : Lymphedema.
- methods : Hysterectomy.
- mortality : Uterine Cervical Neoplasms.
- pathology : Lymph Nodes.
- radiotherapy : Uterine Cervical Neoplasms.
- surgery : Uterine Cervical Neoplasms.
- Adolescent, Adult, Aged, Combined Modality Therapy, Female, Humans, Lymphatic Metastasis, Middle Aged, Neoplasm Recurrence, Local, Radiation Injuries, Survival Analysis.
Abstract
From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam ratiotherapy. Presence of lymph node metastasis, large lesion (>4 cm in diameter), histologic grade, race (non-caucasian), and age (>40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P < 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy.
Url:
DOI: 10.1016/0090-8258(90)90374-T
Affiliations:
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Le document en format XML
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<term>Adult</term>
<term>Aged</term>
<term>Combined Modality Therapy</term>
<term>Female</term>
<term>Humans</term>
<term>Hysterectomy (methods)</term>
<term>Lymph Nodes (pathology)</term>
<term>Lymphatic Metastasis</term>
<term>Lymphedema (etiology)</term>
<term>Middle Aged</term>
<term>Neoplasm Recurrence, Local</term>
<term>Radiation Injuries</term>
<term>Survival Analysis</term>
<term>Uterine Cervical Neoplasms (mortality)</term>
<term>Uterine Cervical Neoplasms (radiotherapy)</term>
<term>Uterine Cervical Neoplasms (surgery)</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Association thérapeutique</term>
<term>Femelle</term>
<term>Humains</term>
<term>Hystérectomie ()</term>
<term>Lymphoedème (étiologie)</term>
<term>Lésions radio-induites</term>
<term>Métastase lymphatique</term>
<term>Noeuds lymphatiques (anatomopathologie)</term>
<term>Récidive tumorale locale</term>
<term>Sujet âgé</term>
<term>Tumeurs du col de l'utérus ()</term>
<term>Tumeurs du col de l'utérus (mortalité)</term>
<term>Tumeurs du col de l'utérus (radiothérapie)</term>
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<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Noeuds lymphatiques</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term>
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<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Hysterectomy</term>
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<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Uterine Cervical Neoplasms</term>
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<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Tumeurs du col de l'utérus</term>
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<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Lymph Nodes</term>
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<term>Adult</term>
<term>Aged</term>
<term>Combined Modality Therapy</term>
<term>Female</term>
<term>Humans</term>
<term>Lymphatic Metastasis</term>
<term>Middle Aged</term>
<term>Neoplasm Recurrence, Local</term>
<term>Radiation Injuries</term>
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<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Association thérapeutique</term>
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<front><div type="abstract" xml:lang="en">From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam ratiotherapy. Presence of lymph node metastasis, large lesion (>4 cm in diameter), histologic grade, race (non-caucasian), and age (>40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P < 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy.</div>
</front>
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<name sortKey="Berchuck, Andrew" sort="Berchuck, Andrew" uniqKey="Berchuck A" first="Andrew" last="Berchuck">Andrew Berchuck</name>
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<name sortKey="Montana, Gustavo" sort="Montana, Gustavo" uniqKey="Montana G" first="Gustavo" last="Montana">Gustavo Montana</name>
<name sortKey="Soper, John T" sort="Soper, John T" uniqKey="Soper J" first="John T." last="Soper">John T. Soper</name>
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