Evaluation of Surgical Approaches and Use of Adjuvant Radiotherapy with Respect to Oncologic Outcomes in the Management of Clinically Early-Stage Cervical Carcinoma.
Laura BurgessWafa AlDuwaisanTinghua ZhangKrystine LupeMichael Fung-Kee-FungWylam FaughtTien LeRajiv SamantPublished in: Current oncology (Toronto, Ont.) (2022)
The standard of care for early-stage cervix cancer is radical hysterectomy with pelvic lymphadenectomy. Adjuvant radiotherapy (RT) or chemoradiotherapy may be administered to reduce the risk of recurrence in patients considered to be at elevated risk based on a combination of pathologic factors. We performed a retrospective review to determine oncologic outcomes in patients treated for early-stage cervix cancer and to determine if surgical approach impacted oncologic outcomes or the decision to use adjuvant therapy. In total, 174 women underwent radical hysterectomy and pelvic lymphadenectomy over the 15-year period. Most of these women (146) had open surgery and 28 had minimally invasive surgery (MIS). In total, 81 had adjuvant pelvic RT; 76 in the open surgery group (52%) and 5 in the MIS group (18%). Five-year PFS and OS, respectively, were 84% and 91%. Five-year PFS was significantly lower in patients who had MIS vs. open surgery, without a difference in 5-year OS, suggesting MIS should be avoided. Five-year PFS was the same with RT or with its omission, despite those treated with RT having higher risk disease. We have demonstrated excellent outcomes in patients with early-stage cervix cancer after primary surgery and selective use of RT, with few recurrences and excellent survival.
Keyphrases
- early stage
- minimally invasive
- rectal cancer
- coronary artery bypass
- robot assisted
- sentinel lymph node
- papillary thyroid
- locally advanced
- squamous cell
- end stage renal disease
- polycystic ovary syndrome
- surgical site infection
- healthcare
- prostate cancer
- squamous cell carcinoma
- chronic kidney disease
- radical prostatectomy
- ejection fraction
- preterm birth
- type diabetes
- percutaneous coronary intervention
- neoadjuvant chemotherapy
- palliative care
- radiation therapy
- insulin resistance
- pregnancy outcomes
- skeletal muscle
- lymph node
- prognostic factors
- pain management
- pregnant women
- young adults
- weight loss
- breast cancer risk
- glycemic control
- patient reported