Back to Search
Start Over
Radiation Therapy of Pelvic Recurrence after Radical Hysterectomy for Cervical Carcinoma
- Source :
- Gynecologic Oncology. 70:241-246
- Publication Year :
- 1998
- Publisher :
- Elsevier BV, 1998.
-
Abstract
- Objectives. To evaluate the efficacy of radiation therapy and potential prognostic factors in patients treated for pelvic recurrence of cervical carcinoma after radical hysterectomy. Materials. The records of 50 patients treated between 1964 and 1994 for an isolated pelvic recurrence of cervical carcinoma a median of 10.5 months after initial radical hysterectomy were retrospectively reviewed. Patients were categorized according to the extent of disease on clinical examination as group 1, mucosal involvement only (5); group 2, paravaginal extension (11); group 3, central recurrence with pelvic wall extension (13); and group 4, recurrences limited to the pelvic sidewall (21). Seven patients with group 3 or 4 disease who had a poor performance status were treated with palliative intent using hypofractionated radiotherapy. The remaining 43 patients were treated with curative intent, 33 with radiotherapy only and 10 with a combination of cisplatin-based chemotherapy and radiotherapy. Survival rates were calculated from the date of initial recurrence. Median follow-up of surviving patients was 109 months. Results. The overall 5-year survival rate was 33% for all 50 patients (median survival, 18 months), 39% for the 43 patients treated with curative intent, and 25% for patients with isolated sidewall recurrences treated with curative intent. The survival rate was 69% for patients with group 1 and 2 disease and 18% for those treated with curative intent for group 3 disease ( P = 0.07). The survival rate was better for patients with recurrent squamous carcinomas (51%) than for those with adenocarcinomas (14%) ( P = 0.05). Three group 4 patients who survived more than 5 years were treated with external-beam radiation alone. Eight-one percent of patients who had a second recurrence had evidence of disease progression. Three patients experienced late treatment complications. Conclusions. Patients who experience an isolated recurrence of cervical cancer after initial radical hysterectomy have an excellent prognosis if disease does not involve the pelvic wall. Occasional long-term survivors of recurrent disease involving the pelvic wall justify an aggressive treatment approach.
- Subjects :
- Adult
medicine.medical_specialty
medicine.medical_treatment
Brachytherapy
Uterine Cervical Neoplasms
Physical examination
Adenocarcinoma
Hysterectomy
Disease-Free Survival
medicine
Carcinoma
Humans
Radical Hysterectomy
Survival rate
Aged
Cervical cancer
Gold Radioisotopes
medicine.diagnostic_test
business.industry
Obstetrics and Gynecology
Radiotherapy Dosage
Middle Aged
medicine.disease
Surgery
Survival Rate
Radiation therapy
Oncology
Carcinoma, Squamous Cell
Female
Neoplasm Recurrence, Local
business
Subjects
Details
- ISSN :
- 00908258
- Volume :
- 70
- Database :
- OpenAIRE
- Journal :
- Gynecologic Oncology
- Accession number :
- edsair.doi.dedup.....22d858dd29d3da8e879ce91440e7137a