TY - JOUR
T1 - Postoperative irradiation in cervical cancer
T2 - Prognostic factors and outcome
AU - Grigsby, Perry W.
PY - 2004/3/1
Y1 - 2004/3/1
N2 - Purpose: The aim of this study was to evaluate prognostic factors and outcomes in patients with cervical cancer who underwent hysterectomy followed by pelvic irradiation. Methods: This was a retrospective chart review of 140 patients with carcinoma of the cervix. The indications for irradiation were an incidental finding of invasive cancer, positive lymph nodes, parametrial extension of tumor, and positive or close margins. Results: The 10-year cause-specific and overall survival rates were 72% and 69%, respectively. Recurrences developed at the following sites: five in the pelvis, four in the pelvis and with distant metastasis, and 13 with distant metastasis. Parametrial extension of tumor was the only significant prognostic factor for developing recurrent disease (p=0.004). Complications were grade 3 in 10 and grade 4 in 18. Leg edema occurred in patients undergoing radical hysterectomy and lymph node dissection, but not in patients undergoing simple hysterectomy (p=0.01, and was more likely if irradiation was begun within six weeks of surgery compared with starting irradiation after six weeks (p=0.02). Conclusion: Pelvic irradiation produced pelvic control of disease in 94%. Distant metastasis was the most common site of failure. Chronic toxicity was greatest if irradiation was begun less than six weeks postoperatively.
AB - Purpose: The aim of this study was to evaluate prognostic factors and outcomes in patients with cervical cancer who underwent hysterectomy followed by pelvic irradiation. Methods: This was a retrospective chart review of 140 patients with carcinoma of the cervix. The indications for irradiation were an incidental finding of invasive cancer, positive lymph nodes, parametrial extension of tumor, and positive or close margins. Results: The 10-year cause-specific and overall survival rates were 72% and 69%, respectively. Recurrences developed at the following sites: five in the pelvis, four in the pelvis and with distant metastasis, and 13 with distant metastasis. Parametrial extension of tumor was the only significant prognostic factor for developing recurrent disease (p=0.004). Complications were grade 3 in 10 and grade 4 in 18. Leg edema occurred in patients undergoing radical hysterectomy and lymph node dissection, but not in patients undergoing simple hysterectomy (p=0.01, and was more likely if irradiation was begun within six weeks of surgery compared with starting irradiation after six weeks (p=0.02). Conclusion: Pelvic irradiation produced pelvic control of disease in 94%. Distant metastasis was the most common site of failure. Chronic toxicity was greatest if irradiation was begun less than six weeks postoperatively.
KW - Cervix
KW - Irradiation
KW - Postoperative
UR - http://www.scopus.com/inward/record.url?scp=2442651263&partnerID=8YFLogxK
M3 - Review article
C2 - 15176605
AN - SCOPUS:2442651263
SN - 0288-2043
VL - 22
SP - 106
EP - 110
JO - Radiation Medicine - Medical Imaging and Radiation Oncology
JF - Radiation Medicine - Medical Imaging and Radiation Oncology
IS - 2
ER -