Radical surgery with individualized postoperative radiation for stage ib cervical cancer; Oncologic outcomes and severe complications Journal Article


Authors: Sandadi, S.; Tanner, E. J.; Khoury-Collado, F.; Kostolias, A.; Makker, V.; Chi, D. S.; Sonoda, Y.; Alektiar, K. M.; Barakat, R. R.; Abu-Rustum, N. R.
Article Title: Radical surgery with individualized postoperative radiation for stage ib cervical cancer; Oncologic outcomes and severe complications
Abstract: Objective: The objective of this study was to compare morbidity and outcome following radical surgery with or without adjuvant radiation therapy (RT) in the treatment of stages IB1-IB2 cervical carcinoma. Methods: We retrospectively identified 222 patients with stages IB1-IB2 cervical carcinoma treated initially with radical hysterectomy or radical trachelectomy with or without adjuvant RT from February 2000 to November 2009. All grade 3 or higher complicationsVthose requiring interventional radiology, endoscopic evaluation, or operative interventionVwere documented. Results: One hundred fifty-eight patients (71%) underwent radical hysterectomy; 64 (29%) underwent radical trachelectomy. One hundred fifty-three patients (69%) underwent surgery alone; 69 (31%) received adjuvant radiation with or without chemosensitization. There was a statistically significant difference in the rate of total grades 1 to 5 late complications between the surgery-alone and surgery ± RT groups (12% vs 32%, respectively; P G 0.001); however, the rate of grade 3 or higher complications was similar (5% vs 4%, respectively; P = 0.999). The progression-free and overall survival rates of the entire cohort were both 95%. The 5-year progression-free survival rates for the surgery-alone and surgery ± RT groups were 93% and 90% (P = 0.172). The overall survival rates were 96% and 91%, respectively (P = 0.332). Conclusions: The majority of women with stages IB1-IB2 cervical cancer undergoing radical surgery do not require adjuvant RT, have excellent oncologic outcome, and have low severe complication rates. Nearly one third of our patients required postoperative radiation, with no statistically significant increase in severe complication rate and with similar oncologic outcomes compared with the surgery-only cohort. These data support the continued practice of radical surgery with individualized postoperative radiation for these patients. © 2013 by IGCS and ESGO.
Keywords: complications; radical surgery; cervical carcinoma ib
Journal Title: International Journal of Gynecological Cancer
Volume: 23
Issue: 3
ISSN: 1048-891X
Publisher: Lippincott Williams & Wilkins  
Date Published: 2013-03-01
Start Page: 553
End Page: 558
Language: English
PROVIDER: scopus
PUBMED: 23392402
DOI: 10.1097/IGC.0b013e3182849d53
DOI/URL:
Notes: --- - "Export Date: 1 May 2013" - "CODEN: IJGCE" - ":doi 10.1097/IGC.0b013e3182849d53" - "Source: Scopus"
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MSK Authors
  1. Vicky Makker
    265 Makker
  2. Richard R Barakat
    629 Barakat
  3. Dennis S Chi
    707 Chi
  4. Kaled M Alektiar
    333 Alektiar
  5. Yukio Sonoda
    473 Sonoda
  6. Samith Sandadi
    12 Sandadi
  7. Edward James Tanner
    40 Tanner