A pilot study of adjuvant therapy in patients with cervical cancer at high risk of recurrence after radical hysterectomy and pelvic lymphadenectomy Journal Article


Authors: Wertheim, M. S.; Hakes, T. B.; Daghestani, A. N.; Nori, D.; Smith, D. H.; Lewis, J. L. Jr
Article Title: A pilot study of adjuvant therapy in patients with cervical cancer at high risk of recurrence after radical hysterectomy and pelvic lymphadenectomy
Abstract: The prognosis after surgical therapy (radical hysterectomy and pelvic lymphadenectomy) of stages IB and IIA carcinoma of the cervix is affected by several histopathologic findings within the resected specimen. Patients at high risk of recurrence include those with involved pelvic lymph nodes, lymphatic or vascular invasion in the cervix, tumor size >4 cm, grade 3 lesions, adenosquamous histology, parametrial invasion, and evidence of locally metastatic (noncontiguous) disease. We report the results of adjuvant chemotherapy (cisplatin and bleomycin) and pelvic radiotherapy in 32 patients with cervix cancer deemed to be at high risk of recurrence after radical hysterectomy and pelvic lymphadenectomy. The continuous disease-free survival rate for the 32 evaluable patients is 84% at a mean and median follow-up time of 28 months. Three patients are dead of disease and 2 patients are alive after treatment of local recurrences giving a survival rate of 91%. The 2 patients who are alive after disease recurrence demonstrated only locally recurrent disease while the 3 patients who have died with recurrent disease relapsed both locally and systemically. Complications of this treatment program were not significantly greater than those observed in prior studies using the combination of surgery and adjuvant radiotherapy without chemotherapy. When compared with the results from historical controls in a large series of similar patients at the same institution, the results in this pilot study are encouraging and would seem to justify a randomized prospective clinical trial.
Keywords: survival; clinical article; cancer recurrence; cisplatin; cancer combination chemotherapy; chemotherapy; hysterectomy; lymphadenectomy; nephrotoxicity; nausea; vomiting; deep vein thrombosis; lymphatic system; gastrointestinal toxicity; kidney; bleomycin; drug therapy; mitomycin; adverse drug reaction; therapy; intravenous drug administration; uterine cervix carcinoma; female genital system; intoxication; prognosis; human; priority journal; peripheral vascular system
Journal Title: Journal of Clinical Oncology
Volume: 3
Issue: 7
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1985-07-01
Start Page: 912
End Page: 916
Language: English
DOI: 10.1200/jco.1985.3.7.912
PROVIDER: scopus
PUBMED: 2410573
DOI/URL:
Notes: Article -- Export Date: 26 October 2021 -- Source: Scopus
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  1. Deborah Helen Smith
    11 Smith
  2. Thomas B Hakes
    115 Hakes
  3. John   Lewis
    132 Lewis
  4. Dattatreyudu Nori
    38 Nori