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Postoperative radiotherapy use and patterns of care analysis for node positive or parametria positive cervical cancer.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2010 Dec; Vol. 119 (3), pp. 411-6. Date of Electronic Publication: 2010 Sep 06. - Publication Year :
- 2010
-
Abstract
- Objective: The objective of this study is to perform a patterns of care analysis for post-hysterectomy patients with node positive (LN+) or parametria positive cervical cancer.<br />Methods: A retrospective analysis was conducted utilizing the Surveillance, Epidemiology and End Results (SEER) Program from 1973 to 2006. We identified 2247 women with cervical carcinoma who had undergone hysterectomy and were found to have LN+ and/or positive parametria.<br />Results: Of the 2247 identified, 80.1% (1800) received postoperative radiotherapy (RT) while 19.9% (447) did not. Of those receiving RT, a significantly greater proportion had worse risk factors including higher clinical stage, and nodal bulk yet cause-specific survival (CSS) was equivalent between the two groups. RT utilization has increased over time from 67.2% in the cohort analyzed from 1973 to 1982 to 81.8% in the cohort analyzed from 2004 to 2006 (p = 0.0003). Blacks had worse CSS than whites (HR 1.35, 95% CI [1.05, 1.75]; p = 0.02). The proportion of those receiving RT was lower in blacks than whites (74.7% vs. 80.5%; p = 0.0358). From 1973 to 1982, 87.5% of blacks received RT while 62% of whites received RT (p = 0.0463). From 2004 to 2006, 64.4% of blacks received RT while 83.0% of whites received RT (p = 0.0024).<br />Conclusions: Despite randomized data supporting the use of postoperative concurrent chemoradiotherapy for LN+ or parametria positive cervical cancer, the proportion of blacks not receiving RT is increasing over time. This is the largest patterns of care analysis to date of RT in patients with LN+ and/or parametria positive cervical cancer.<br /> (Copyright © 2010 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
Gynecology methods
Humans
Lymphatic Metastasis
Medical Oncology methods
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Postoperative Care
Radiotherapy, Adjuvant statistics & numerical data
Retrospective Studies
SEER Program
United States epidemiology
Uterine Cervical Neoplasms epidemiology
Uterine Cervical Neoplasms pathology
Young Adult
Practice Patterns, Physicians' statistics & numerical data
Uterine Cervical Neoplasms radiotherapy
Uterine Cervical Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 119
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 20817225
- Full Text :
- https://doi.org/10.1016/j.ygyno.2010.07.012