Treatment patterns of FIGO Stage IB2 cervical cancer: A single-institution experience of radical hysterectomy with individualized postoperative therapy and definitive radiation therapy Journal Article

   

Authors:	Zivanovic, O.; Alektiar, K. M.; Sonoda, Y.; Zhou, Q.; Iasonos, A.; Tew, W. P.; Diaz, J. P.; Chi, D. S.; Barakat, R. R.; Abu-Rustum, N. R.
Article Title:	Treatment patterns of FIGO Stage IB2 cervical cancer: A single-institution experience of radical hysterectomy with individualized postoperative therapy and definitive radiation therapy
Abstract:	Objective: The treatment of FIGO stage IB2 cervical cancer is controversial. Our aim was to assess treatment patterns, outcomes, and complications in patients with stage IB2 cervical cancer. Methods: A retrospective study of patients with stage IB2 cervical carcinoma at a single institution between January 1982 and September 2006 was performed. To adequately control treatment variables, we only included patients who underwent their entire treatment at our institution. Toxicity was assessed using NCI Common Toxicity Criteria (CTC). Results: We identified 82 patients, of whom 47 met the strict inclusion criteria. Of these, 27 patients (57%) underwent primary radical hysterectomy (RH) and 20 (43%) were treated with definitive radiation/chemoradiation therapy (RT/CRT). Patients selected for RT/CRT had a higher American Society of Anesthesiologist (ASA) score than those selected for surgery (P = 0.037). The 3-year progression free survival rate was 52% for the RH group and 55% for the RT/CRT group (P = 0.977). The 3-year overall survival rates were 72% and 55%, respectively (P = 0.161). Overall, 52% of patients in the RH group received postoperative radiation therapy as part of their adjuvant treatment. CTC grade 3, 4, and 5 complications affected 5 patients (19%) in the RH group and 3 (15%) in the RT/CRT group. Conclusion: Both RH and definitive RT/CRT are adequate management strategies for patients with FIGO stage IB2 cervical cancer. However, there was a subset of patients in whom RH as monotherapy was appropriate. Further studies are needed to evaluate the role of new preoperative models that will accurately identify these patients. © 2008 Elsevier Inc. All rights reserved.
Keywords:	adult; clinical article; controlled study; treatment outcome; aged; disease-free survival; middle aged; young adult; fatigue; cancer recurrence; cisplatin; diarrhea; multimodality cancer therapy; skin toxicity; postoperative care; combined modality therapy; cancer staging; neurotoxicity; hysterectomy; neoplasm staging; neoplasm recurrence, local; blood toxicity; nausea; vagina disease; deep vein thrombosis; abdominal pain; fever; lung embolism; gastrointestinal toxicity; heart infarction; uterine cervix cancer; brachytherapy; bleomycin; intermethod comparison; colitis; external beam radiotherapy; cystitis; urogenital tract disease; wound infection; uterine cervical neoplasms; brain hemorrhage; leg edema; radical hysterectomy; heart muscle ischemia; rectum hemorrhage; feces incontinence; lymphocele; stress incontinence; chemoradiation therapy; proctitis; figo stage ib2 cervical carcinoma; neurogenic bladder; vagina stenosis; wasting syndrome
Journal Title:	Gynecologic Oncology
Volume:	111
Issue:	2
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2008-11-01
Start Page:	265
End Page:	270
Language:	English
DOI:	10.1016/j.ygyno.2008.07.050
PUBMED:	18774596
PROVIDER:	scopus
PMCID:	PMC3932675
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-55649119590&partnerID=40&md5=bdfe2d3c15a38572705cceb959d7cb3e
Notes:	--- - "Export Date: 17 November 2011" - "CODEN: GYNOA" - "Source: Scopus"

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