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Postoperative radiotherapy use and patterns of care analysis for node positive or parametria positive cervical cancer.

Authors :
Ghia AJ
Neeley ES
Gaffney DK
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.)

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