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Postoperative radiation rates in stage IIA1 cervical cancer: Is surgical treatment justified? An Israeli Gynecologic Oncology Group Study
- Source :
- Gynecologic Oncology. 150:288-292
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Objectives Data on the outcome of stage IIA1 cervical cancer is limited, as these tumors comprise a small percentage of early tumors. NCCN guidelines suggest consideration of surgical management for small tumors with vaginal involvement. Our objective was to evaluate the risk of adjuvant radiotherapy in stage IIA1 cervical cancer and its associated features, in order to improve selection of patients for surgical management. Methods A retrospective cohort study comparing surgically treated cervical cancer patients with stage IB1 and stage IIA1 disease. Women treated between 2000 and 2015 in ten Israeli medical centers were included. Patient and disease features were compared between stages. The relative risk (Fisher's exact test) of receiving post-operative radiation was calculated and compared for each risk factor. A general linear model (GLM) was used for multivariable analysis. Results 199 patients were included, of whom 21 had stage IIA1 disease. Most features were comparable for stage IB1 and stage IIA1 disease, although patients with vaginal involvement were more likely to have close surgical margins (23.8% vs 8.5%, p = 0.03). Patients with stage IIA1 disease were more likely to receive radiation after surgery (76% vs. 46%, RR = 1.65 (1.24–2.2), p = 0.011). Vaginal involvement as well as depth of stromal invasion, LVSI and lymph node metastases were independent predictors of radiation on multivariable general linear modeling. Conclusions Cervical cancer patients with vaginal involvement are highly more likely to require postoperative radiation. We recommend careful evaluation of these patients before surgical management is offered.
- Subjects :
- Stage IIA Cervical Cancer
medicine.medical_specialty
Uterine Cervical Neoplasms
Gynecologic oncology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Risk factor
Stage (cooking)
Neoplasm Staging
Retrospective Studies
Postoperative Care
Cervical cancer
030219 obstetrics & reproductive medicine
business.industry
Obstetrics and Gynecology
Retrospective cohort study
Middle Aged
medicine.disease
Surgery
Exact test
Oncology
030220 oncology & carcinogenesis
Relative risk
Female
Radiotherapy, Adjuvant
business
Subjects
Details
- ISSN :
- 00908258
- Volume :
- 150
- Database :
- OpenAIRE
- Journal :
- Gynecologic Oncology
- Accession number :
- edsair.doi.dedup.....f7a0e4e294509f87d8ab997aa66f26b0