Prognostic Factors and Morbidities After Completion Surgery in Patients Undergoing Initial Chemoradiation Therapy for Locally Advanced Cervical Cancer
Identifieur interne : 003120 ( Pmc/Curation ); précédent : 003119; suivant : 003121Prognostic Factors and Morbidities After Completion Surgery in Patients Undergoing Initial Chemoradiation Therapy for Locally Advanced Cervical Cancer
Auteurs : Cyril Touboul ; Catherine Uzan ; Audrey Mauguen ; Sebastien Gouy ; Annie Rey ; Patricia Pautier ; Catherine Lhommé ; Pierre Duvillard ; Christine Haie-Meder ; Philippe Morice [France]Source :
- The Oncologist [ 1083-7159 ] ; 2010.
Abstract
The study evaluates the prognostic factors and morbidities of patients undergoing completion surgery for locally advanced-stage cervical cancer after initial chemoradiation therapy.
Url:
DOI: 10.1634/theoncologist.2009-0295
PubMed: 20332143
PubMed Central: 3227965
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A" first="Audrey" last="Mauguen">Audrey Mauguen</name><affiliation><nlm:aff id="aff2">Biostatistics,</nlm:aff></affiliation></author><author><name sortKey="Gouy, Sebastien" sort="Gouy, Sebastien" uniqKey="Gouy S" first="Sebastien" last="Gouy">Sebastien Gouy</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Rey, Annie" sort="Rey, Annie" uniqKey="Rey A" first="Annie" last="Rey">Annie Rey</name><affiliation><nlm:aff id="aff2">Biostatistics,</nlm:aff></affiliation></author><author><name sortKey="Pautier, Patricia" sort="Pautier, Patricia" uniqKey="Pautier P" first="Patricia" last="Pautier">Patricia Pautier</name><affiliation><nlm:aff id="aff3">Oncology,</nlm:aff></affiliation></author><author><name sortKey="Lhomme, Catherine" sort="Lhomme, Catherine" uniqKey="Lhomme C" first="Catherine" last="Lhommé">Catherine Lhommé</name><affiliation><nlm:aff id="aff3">Oncology,</nlm:aff></affiliation></author><author><name sortKey="Duvillard, Pierre" sort="Duvillard, Pierre" uniqKey="Duvillard P" first="Pierre" last="Duvillard">Pierre Duvillard</name><affiliation><nlm:aff wicri:cut=" and" id="aff5">Radiotherapy</nlm:aff></affiliation></author><author><name sortKey="Haie Meder, Christine" sort="Haie Meder, Christine" uniqKey="Haie Meder C" first="Christine" last="Haie-Meder">Christine Haie-Meder</name><affiliation><nlm:aff wicri:cut=", and" id="aff4">Pathology</nlm:aff></affiliation></author><author><name sortKey="Morice, Philippe" sort="Morice, Philippe" uniqKey="Morice P" first="Philippe" last="Morice">Philippe Morice</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6">University Paris Sud, Institut Gustave Roussy, Villejuif, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>University Paris Sud, Institut Gustave Roussy, Villejuif</wicri:regionArea></affiliation></author></analytic><series><title level="j">The Oncologist</title><idno type="ISSN">1083-7159</idno><idno type="eISSN">1549-490X</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The study evaluates the prognostic factors and morbidities of patients undergoing completion surgery for locally advanced-stage cervical cancer after initial chemoradiation therapy.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Oncologist</journal-id><journal-id journal-id-type="iso-abbrev">Oncologist</journal-id><journal-id journal-id-type="pmc">oncologist</journal-id><journal-id journal-id-type="hwp">theoncologist</journal-id><journal-id journal-id-type="publisher-id">The Oncologist</journal-id><journal-title-group><journal-title>The Oncologist</journal-title></journal-title-group><issn pub-type="ppub">1083-7159</issn><issn pub-type="epub">1549-490X</issn><publisher><publisher-name>AlphaMed Press</publisher-name><publisher-loc>Durham, NC, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">20332143</article-id><article-id pub-id-type="pmc">3227965</article-id><article-id pub-id-type="publisher-id">3587731</article-id><article-id pub-id-type="doi">10.1634/theoncologist.2009-0295</article-id><article-categories><subj-group subj-group-type="heading"><subject>Gynecologic Oncology</subject></subj-group></article-categories><title-group><article-title>Prognostic Factors and Morbidities After Completion Surgery in Patients Undergoing Initial Chemoradiation Therapy for Locally Advanced Cervical Cancer</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Touboul</surname><given-names>Cyril</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Uzan</surname><given-names>Catherine</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Mauguen</surname><given-names>Audrey</given-names></name><xref ref-type="aff" rid="aff2"><sup>b</sup></xref></contrib><contrib contrib-type="author"><name><surname>Gouy</surname><given-names>Sebastien</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref></contrib><contrib contrib-type="author"><name><surname>Rey</surname><given-names>Annie</given-names></name><xref ref-type="aff" rid="aff2"><sup>b</sup></xref></contrib><contrib contrib-type="author"><name><surname>Pautier</surname><given-names>Patricia</given-names></name><xref ref-type="aff" rid="aff3"><sup>c</sup></xref></contrib><contrib contrib-type="author"><name><surname>Lhommé</surname><given-names>Catherine</given-names></name><xref ref-type="aff" rid="aff3"><sup>c</sup></xref></contrib><contrib contrib-type="author"><name><surname>Duvillard</surname><given-names>Pierre</given-names></name><xref ref-type="aff" rid="aff5"><sup>e</sup></xref></contrib><contrib contrib-type="author"><name><surname>Haie-Meder</surname><given-names>Christine</given-names></name><xref ref-type="aff" rid="aff4"><sup>d</sup></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Morice</surname><given-names>Philippe</given-names></name><xref ref-type="aff" rid="aff1"><sup>a</sup></xref><xref ref-type="aff" rid="aff6"><sup>f</sup></xref></contrib><aff id="aff1">Departments of<sup>a</sup>Gynecologic Surgery,</aff><aff id="aff2"><sup>b</sup>Biostatistics,</aff><aff id="aff3"><sup>c</sup>Oncology,</aff><aff id="aff4"><sup>d</sup>Pathology, and</aff><aff id="aff5"><sup>e</sup>Radiotherapy and</aff><aff id="aff6"><sup>f</sup>University Paris Sud, Institut Gustave Roussy, Villejuif, France</aff></contrib-group><author-notes><corresp>Correspondence: Philippe Morice, M.D., Ph.D., Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805 Villejuif, France. Telephone:
<phone>33-1-42-11-44-39</phone>; Fax:
<fax>33-1-42-11-52-13</fax>; e-mail: <email>morice@igr.fr</email></corresp><fn fn-type="conflict"><p><bold>Disclosures</bold></p><p><bold>Cyril Touboul:</bold> None; <bold>Catherine Uzan;</bold> None; <bold>Audrey Mauguen:</bold> None; <bold>Sebastien Gouy:</bold> None; <bold>Annie Rey:</bold> None; <bold>Patricia Pautier:</bold> None; <bold>Catherine Lhommé:</bold> None; <bold>Pierre Duvillard:</bold> None; <bold>Christine Haie-Meder:</bold> None; <bold>Philippe Morice:</bold> None.</p><p>Section editors <bold>Peter G. Harper</bold> and <bold>Dennis S. Chi</bold> have disclosed no financial relationships relevant to the content of this article.</p><p>The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias.</p></fn></author-notes><pub-date pub-type="ppub"><month>4</month><year>2010</year></pub-date><pub-date pub-type="epub"><day>23</day><month>3</month><year>2010</year></pub-date><volume>15</volume><issue>4</issue><fpage>405</fpage><lpage>415</lpage><history><date date-type="received"><day>24</day><month>11</month><year>2009</year></date><date date-type="accepted"><day>1</day><month>3</month><year>2010</year></date></history><permissions><copyright-statement>©AlphaMed Press</copyright-statement><copyright-year>2010</copyright-year></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="onc00410000405.pdf"></self-uri><abstract abstract-type="precis"><p>The study evaluates the prognostic factors and morbidities of patients undergoing completion surgery for locally advanced-stage cervical cancer after initial chemoradiation therapy.</p></abstract><abstract abstract-type="objectives"><title>Learning Objectives</title><p>After completing this course, the reader will be able to:
<list list-type="order"><list-item><p>Rate the prognostic factors for overall survival in patients undergoing completion surgery after initial chemoradiation therapy (CRT) for locally advanced cervical cancer.</p></list-item><list-item><p>In cervical cancer patients undergoing completion surgery, consider using laparoscopy to decrease the morbidity of the surgery.</p></list-item><list-item><p>In cervical cancer patients undergoing completion surgery, use PET-CT imaging to improve detection of para-aortic involvement.</p></list-item></list></p><p>This article is available for continuing medical education credit at <ext-link ext-link-type="uri" xlink:href="http://CME.TheOncologist.com">CME.TheOncologist.com</ext-link></p></abstract><abstract><sec><title>Purpose.</title><p>The aim of this study was to evaluate the prognostic factors and morbidities of patients undergoing completion surgery for locally advanced-stage cervical cancer after initial chemoradiation therapy (CRT).</p></sec><sec><title>Patients and Methods.</title><p>Patients fulfilling the following inclusion criteria were studied: stage IB2–IVA cervical carcinoma, tumor initially confined to the pelvic cavity on conventional imaging, pelvic external radiation therapy with delivery of 45 Gy to the pelvic cavity and concomitant chemotherapy (cisplatin, 40 mg/m<sup>2</sup> per week) followed by uterovaginal brachytherapy, and completion surgery after the end of radiation therapy including at least a hysterectomy.</p></sec><sec><title>Results.</title><p>One-hundred fifty patients treated in 1998–2007 fulfilled the inclusion criteria. Prognostic factors for overall survival in the multivariate analysis were the presence and level of nodal spread (positive pelvic nodes alone: hazard ratio [HR], 2.03; positive para-aortic nodes: HR, 5.46; <italic>p</italic> < .001) and the presence and size of residual disease (RD) in the cervix (<italic>p</italic> = .02). Thirty-seven (25%) patients had 55 postoperative complications. The risk for complications was higher with a radical hysterectomy (<italic>p</italic> = .04) and the presence of cervical RD (<italic>p</italic> = .01).</p></sec><sec><title>Conclusion.</title><p>In this series, the presence and size of RD and histologic nodal involvement were the strongest prognostic factors. Such results suggest that the survival of patients treated using CRT for locally advanced cervical cancer could potentially be enhanced by improving the rate of complete response in the irradiated area (cervix or pelvic nodes) and by initially detecting patients with para-aortic spread so that treatment could be adapted in such patients. The morbidity of completion surgery is high in this context.</p></sec></abstract><kwd-group><kwd>Chemoradiation therapy</kwd><kwd>Completion surgery</kwd><kwd>Locally advanced cervical cancer</kwd><kwd>Morbidities</kwd><kwd>Nodal involvement</kwd><kwd>Prognostic factors</kwd><kwd>Residual disease</kwd><kwd>Survival</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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