Postoperative radiotherapy following inadvertent simple hysterectomy versus radical hysterectomy for cervical carcinoma. 2011

Daya Nand Sharma, and Goura Kisor Rath, and Sunesh Kumar, and Neerja Bhatla, and Ajeet Kumar Gandhi, and Piyush Sharma, and Subhash Gupta, and Parmod Kumar Julka
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India. sharmadn@hotmail.com

OBJECTIVE For cervical carcinoma, postoperative radiation therapy (PORT) following radical hysterectomy (RH) is indicated for certain adverse pathological factors. Simple hysterectomy (SH) is considered inadequate treatment for invasive cervical carcinoma and PORT is required for all such cases. Clinical outcome of patients receiving PORT following SH and RH may be different. The aim of our retrospective study is to compare the results of PORT following inadvertent SH or RH in cervical carcinoma. METHODS During years 2003-2005, we treated 83 patients with cervical carcinoma with PORT following either SH (Group SH, 33 patients) or RH (Group RH, 50 patients). All patients were treated with pelvic external beam radiation therapy (EBRT) followed by intravaginal brachytherapy (IVBT). The endpoints of the study were local control, recurrence free survival (RFS) and delayed complications. RESULTS Median follow period up was 34 months (range 2-75 months). Local control rate observed in Gp SH and RH was 70% and 88% respectively with a p value of <0.05. Cumulative 5-year overall survival (OS) for combined group was 62%. Group RH patients had significantly better 5-year RFS than Group SH patients (72% and 49% respectively; p value 0.04). The frequency of Grade III-IV toxicity (bladder, rectum, and bowel) in Group SH versus Group RH was 6% vs 8% respectively (p value 0.1). The pedal lymph edema was higher in Group RH patients (10% vs 3%, p value<0.05). CONCLUSIONS PORT provides greater clinical benefit in patients who had undergone RH than SH for early stage invasive cervical carcinoma.

UI MeSH Term Description Entries
D007044 Hysterectomy Excision of the uterus. Hysterectomies
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D001918 Brachytherapy A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. Curietherapy,Implant Radiotherapy,Plaque Therapy, Radioisotope,Radioisotope Brachytherapy,Radiotherapy, Interstitial,Radiotherapy, Intracavity,Radiotherapy, Surface,Brachytherapy, Radioisotope,Interstitial Radiotherapy,Intracavity Radiotherapy,Radioisotope Plaque Therapy,Radiotherapy, Implant,Surface Radiotherapy,Therapy, Radioisotope Plaque
D002583 Uterine Cervical Neoplasms Tumors or cancer of the UTERINE CERVIX. Cancer of Cervix,Cancer of the Cervix,Cancer of the Uterine Cervix,Cervical Cancer,Cervical Neoplasms,Cervix Cancer,Cervix Neoplasms,Neoplasms, Cervical,Neoplasms, Cervix,Uterine Cervical Cancer,Cancer, Cervical,Cancer, Cervix,Cancer, Uterine Cervical,Cervical Cancer, Uterine,Cervical Cancers,Cervical Neoplasm,Cervical Neoplasm, Uterine,Cervix Neoplasm,Neoplasm, Cervix,Neoplasm, Uterine Cervical,Uterine Cervical Cancers,Uterine Cervical Neoplasm
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D053208 Kaplan-Meier Estimate A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995) Kaplan-Meier Survival Curve,Kaplan-Meier Analysis,Kaplan-Meier Survival Curves,Kaplan-Meier Test,Product-Limit Method,Analysis, Kaplan-Meier,Curve, Kaplan-Meier Survival,Curves, Kaplan-Meier Survival,Estimate, Kaplan-Meier,Kaplan Meier Analysis,Kaplan Meier Survival Curve,Kaplan Meier Survival Curves,Kaplan Meier Test,Method, Product-Limit,Methods, Product-Limit,Product Limit Method,Product-Limit Methods,Survival Curve, Kaplan-Meier,Survival Curves, Kaplan-Meier,Test, Kaplan-Meier

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