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Published in: Strahlentherapie und Onkologie 12/2017

01-12-2017 | Original Article

Adjuvant hysterectomy after radiochemotherapy for locally advanced cervical cancer

Authors: Peter Hass, Holm Eggemann, Serban Dan Costa, Atanas Ignatov

Published in: Strahlentherapie und Onkologie | Issue 12/2017

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Abstract

Background

External beam radiation therapy (EBRT) with concomitant chemotherapy (cCT) (=RCT) plus intracavitary (±interstitial) brachytherapy (iBT) is standard of care for advanced cervical cancer. The aim of this study was to evaluate morbidity and survival outcome of simple adjuvant hysterectomy (AH) after EBRT/cCT and to compare it with the standard treatment.

Patients and methods

Patients with FIGO stage III cervical cancer were treated with EBRT/cCT and then divided in two groups: group 1 was further treated with standard intracavitary/interstitial BT, while group 2 underwent AH.

Results

From 881 women with cervical cancer, 248 were eligible for analysis: 161 received iBT and 87 underwent AH. The median follow-up of the study was 53 months. Clinical and pathological characteristics were well balanced in the two groups. After EBRT/cCT, complete clinical response was observed in 121 (48.8%) of 246 patients. Clinical complete response was observed in 81 (50.3%) of 161 patients in group 1. At 6 weeks after EBRT/cCT, 40 (46.0%) of 87 patients in the surgery group had pathological complete response. Intra- and postoperative complications were observed in 10 (11.5%) of 87 cases. The rates of locoregional recurrence and metastasis were similar in both groups. Progression-free (PFS) and disease-specific overall survival (DOS) for these patients were similar between the control and surgery group. Interestingly, PFS and DOS were significantly improved by AH for the patients with residual tumor.

Conclusion

AH could improve survival in patients with residual disease after RCT and is characterized by a low complication rate.
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Metadata
Title
Adjuvant hysterectomy after radiochemotherapy for locally advanced cervical cancer
Authors
Peter Hass
Holm Eggemann
Serban Dan Costa
Atanas Ignatov
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 12/2017
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-017-1174-1

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