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Original Article
Is Surgical Treatment an Option for Locally Advanced Cervical Cancer in the Presence of Central Residual Tumor after Chemoradiotherapy?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):35-42
03-27-2020
Summary
Original ArticleIs Surgical Treatment an Option for Locally Advanced Cervical Cancer in the Presence of Central Residual Tumor after Chemoradiotherapy?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):35-42
03-27-2020Views93See moreAbstract
Objective
To evaluate the outcomes of surgical treatment in patients with chemoradiotherapy (CRT)-resistant and locally advanced cervical cancer (LACC).
Methods
Patients with LACC who underwent surgery due to resistance to CRT between 2005 and 2015 were reviewed retrospectively. Disease-free survival (DFS) and overall survival (OS) related factors were analyzed.
Results
A total of 23 patients were included in the study and the median age was 51 years old. A total of 14 patients (60.8%) experienced recurrence; among these recurrences, 8 of them were local, 5 were distant, 1 was both distant and local. A total of 9 patients (39%) died. The Median DFS and OS durations were 15 and 32 months, respectively. A total of 17 patients (74%) had undergone simple hysterectomy, 4 (17%) radical hysterectomy, and 2 (9%) total pelvic exenteration. Postoperative grade 3 and 4 complications were seen in 12 patients (52%). Macroscopic tumor presence in the pathology specimen was associated with distant recurrence and positive surgical margins with local recurrence (Log-Rank test p = 0.029 and p = 0.048, respectively). The only factor associated with OS was surgical margin positivity (Log-Rank test p = 0.008). The type of surgery, grades 3 and 4 postoperative complications, brachytherapy, and tumor histology were not associated with recurrence.
Conclusion
In patients with LACC, hysterectomy is an option in the presence of a central residual tumor after CRT. However, the risk of grades 3 and 4 complications of performed surgery is high. The presence of macroscopic tumor in the pathology specimen and positive surgical margins are poor prognostic factors. The goal of the surgeon should be to achieve a negative surgical margin. It does not seem important if the surgery is simple or radical.
Views93
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleIs Surgical Treatment an Option for Locally Advanced Cervical Cancer in the Presence of Central Residual Tumor after Chemoradiotherapy?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):35-42
03-27-2020Views93See moreAbstract
Objective
To evaluate the outcomes of surgical treatment in patients with chemoradiotherapy (CRT)-resistant and locally advanced cervical cancer (LACC).
Methods
Patients with LACC who underwent surgery due to resistance to CRT between 2005 and 2015 were reviewed retrospectively. Disease-free survival (DFS) and overall survival (OS) related factors were analyzed.
Results
A total of 23 patients were included in the study and the median age was 51 years old. A total of 14 patients (60.8%) experienced recurrence; among these recurrences, 8 of them were local, 5 were distant, 1 was both distant and local. A total of 9 patients (39%) died. The Median DFS and OS durations were 15 and 32 months, respectively. A total of 17 patients (74%) had undergone simple hysterectomy, 4 (17%) radical hysterectomy, and 2 (9%) total pelvic exenteration. Postoperative grade 3 and 4 complications were seen in 12 patients (52%). Macroscopic tumor presence in the pathology specimen was associated with distant recurrence and positive surgical margins with local recurrence (Log-Rank test p = 0.029 and p = 0.048, respectively). The only factor associated with OS was surgical margin positivity (Log-Rank test p = 0.008). The type of surgery, grades 3 and 4 postoperative complications, brachytherapy, and tumor histology were not associated with recurrence.
Conclusion
In patients with LACC, hysterectomy is an option in the presence of a central residual tumor after CRT. However, the risk of grades 3 and 4 complications of performed surgery is high. The presence of macroscopic tumor in the pathology specimen and positive surgical margins are poor prognostic factors. The goal of the surgeon should be to achieve a negative surgical margin. It does not seem important if the surgery is simple or radical.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
Sexual dysfunction in patients with advanced cervical cancer submitted to exclusive radiotherapy
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):85-90
05-02-2007
Summary
Artigos OriginaisSexual dysfunction in patients with advanced cervical cancer submitted to exclusive radiotherapy
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):85-90
05-02-2007DOI 10.1590/S0100-72032007000200005
Views64PURPOSE: to identify sexual dysfunctions in patients with cancer of the uterine cervix submitted to exclusive radiotherapy, using the high dose rate (HDR) brachytherapy technique. METHODS: a descriptive transversal study from January to June of 2004. The study involved 71 selected patients who had been followed in the pelvis outpatient clinic from the Hospital do Câncer de Pernambuco and selected according to the established profile. Data were collected from a structured questionnaire, complemented by a gynecological exam aimed at investigating complaints of sexual dysfunction after the radiotherapy. Epi-Info 6.04 was the statistical program used to process and analyze the data. Descriptive analysis was done through the mean, median and range. Bivariate analysis was done through the Marginal Homogeneity and McNamara's tests, considering 5% as the level of significance. RESULTS: among the gynecological complications identified, we can highlight fibrosis, stenosis and vaginal atrophy (98.6%, 76.1% and 71.8%, respectively). The sexual dysfunctions identified were: frigidity, lack of lubrication, excitation and orgasm in 76.1% of the cases, lack of sex drive in 40.8% and vaginism in 5.6% of the cases. CONCLUSIONS: sexual dysfunctions are frequent in patients with cancer of the advanced uterine cervix treated with exclusive radiotherapy using the protocol of HDR. Specific attention should be given to the sexual anamnesis and the gynecological exam during these patients' attendance.
Key-words BrachytherapyQuality of lifeQuestionairesSexual dysfunctions, psychologicalUterine cervical neoplasmsSee moreViews64This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisSexual dysfunction in patients with advanced cervical cancer submitted to exclusive radiotherapy
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(2):85-90
05-02-2007DOI 10.1590/S0100-72032007000200005
Views64PURPOSE: to identify sexual dysfunctions in patients with cancer of the uterine cervix submitted to exclusive radiotherapy, using the high dose rate (HDR) brachytherapy technique. METHODS: a descriptive transversal study from January to June of 2004. The study involved 71 selected patients who had been followed in the pelvis outpatient clinic from the Hospital do Câncer de Pernambuco and selected according to the established profile. Data were collected from a structured questionnaire, complemented by a gynecological exam aimed at investigating complaints of sexual dysfunction after the radiotherapy. Epi-Info 6.04 was the statistical program used to process and analyze the data. Descriptive analysis was done through the mean, median and range. Bivariate analysis was done through the Marginal Homogeneity and McNamara's tests, considering 5% as the level of significance. RESULTS: among the gynecological complications identified, we can highlight fibrosis, stenosis and vaginal atrophy (98.6%, 76.1% and 71.8%, respectively). The sexual dysfunctions identified were: frigidity, lack of lubrication, excitation and orgasm in 76.1% of the cases, lack of sex drive in 40.8% and vaginism in 5.6% of the cases. CONCLUSIONS: sexual dysfunctions are frequent in patients with cancer of the advanced uterine cervix treated with exclusive radiotherapy using the protocol of HDR. Specific attention should be given to the sexual anamnesis and the gynecological exam during these patients' attendance.
Key-words BrachytherapyQuality of lifeQuestionairesSexual dysfunctions, psychologicalUterine cervical neoplasmsSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Brachytherapy Archives - Revista Brasileira de Ginecologia e Obstetrícia
