Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy
Identifieur interne : 00DB14 ( Main/Exploration ); précédent : 00DB13; suivant : 00DB15Morbidity and survival patterns in patients after radical hysterectomy and postoperative adjuvant pelvic radiotherapy
Auteurs : James V. Fiorica [États-Unis] ; William S. Roberts [États-Unis] ; Harvey Greenberg [États-Unis] ; Mitchel S. Hoffman [États-Unis] ; James P. Lapolla [États-Unis] ; Denis Cavanagh [États-Unis]Source :
- Gynecologic Oncology [ 0090-8258 ] ; 1990.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Adénocarcinome (), Adénocarcinome (radiothérapie), Analyse de survie, Carcinome épidermoïde (), Carcinome épidermoïde (radiothérapie), Femelle, Humains, Hystérectomie, Lésions radio-induites (anatomopathologie), Maladies gastro-intestinales (étiologie), Récidive tumorale locale, Sujet âgé, Tumeurs du col de l'utérus (), Tumeurs du col de l'utérus (radiothérapie).
- MESH :
- anatomopathologie : Lésions radio-induites.
- radiothérapie : Adénocarcinome, Carcinome épidermoïde, Tumeurs du col de l'utérus.
- étiologie : Maladies gastro-intestinales.
- Adulte, Adulte d'âge moyen, Adénocarcinome, Analyse de survie, Carcinome épidermoïde, Femelle, Humains, Hystérectomie, Récidive tumorale locale, Sujet âgé, Tumeurs du col de l'utérus.
English descriptors
- KwdEn :
- Adenocarcinoma (radiotherapy), Adenocarcinoma (surgery), Adenocarcinoma (therapy), Adult, Aged, Carcinoma, Squamous Cell (radiotherapy), Carcinoma, Squamous Cell (surgery), Carcinoma, Squamous Cell (therapy), Female, Gastrointestinal Diseases (etiology), Humans, Hysterectomy, Middle Aged, Neoplasm Recurrence, Local, Radiation Injuries (pathology), Survival Analysis, Uterine Cervical Neoplasms (radiotherapy), Uterine Cervical Neoplasms (surgery), Uterine Cervical Neoplasms (therapy).
- MESH :
- etiology : Gastrointestinal Diseases.
- pathology : Radiation Injuries.
- radiotherapy : Adenocarcinoma, Carcinoma, Squamous Cell, Uterine Cervical Neoplasms.
- surgery : Adenocarcinoma, Carcinoma, Squamous Cell, Uterine Cervical Neoplasms.
- therapy : Adenocarcinoma, Carcinoma, Squamous Cell, Uterine Cervical Neoplasms.
- Adult, Aged, Female, Humans, Hysterectomy, Middle Aged, Neoplasm Recurrence, Local, Survival Analysis.
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
Affiliations:
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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><affiliations><list><country><li>États-Unis</li></country><region><li>Floride</li></region></list><tree><country name="États-Unis"><region name="Floride"><name sortKey="Fiorica, James V" sort="Fiorica, James V" uniqKey="Fiorica J" first="James V." last="Fiorica">James V. Fiorica</name></region><name sortKey="Cavanagh, Denis" sort="Cavanagh, Denis" uniqKey="Cavanagh D" first="Denis" last="Cavanagh">Denis Cavanagh</name><name sortKey="Greenberg, Harvey" sort="Greenberg, Harvey" uniqKey="Greenberg H" first="Harvey" last="Greenberg">Harvey Greenberg</name><name sortKey="Hoffman, Mitchel S" sort="Hoffman, Mitchel S" uniqKey="Hoffman M" first="Mitchel S." last="Hoffman">Mitchel S. Hoffman</name><name sortKey="Lapolla, James P" sort="Lapolla, James P" uniqKey="Lapolla J" first="James P." last="Lapolla">James P. Lapolla</name><name sortKey="Roberts, William S" sort="Roberts, William S" uniqKey="Roberts W" first="William S." last="Roberts">William S. Roberts</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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