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Evaluation of treatment results and prognostic factors in early-stage cervical carcinoma patients treated with postoperative radiotherapy or radiochemotherapy.

Abstract

PURPOSE
To investigate the clinical features, prognostic factors, and treatment outcome in early-stage cervical carcinoma patients treated with postoperative radiotherapy (RT)/radiochemotherapy (RCT).
METHODS
The records of 256 Stage IB and II cervical cancer patients treated with postoperative RT/RCT from 1992-2007 were retrospectively reviewed. Median age of the patients was 47 (range: 25-78). Two hundred one (78.6%) patients had squamous cell carcinoma and 29 (11.3%) had adenocarcinoma. One hundred and eighty-seven (73.0%) had FIGO Stage IB and 69 (27%) had Stage II disease. Concomitant cisplatin-based chemotherapy was administered to 47 (18.4%) patients. Metastatic lymph node ratio (MLNR), defined as number of metastatic lymph nodes divided by the number of dissected lymph nodes, was 0 in 142 (55.5%) patients, from 1% to 10% in 27 (10.5%) and > 10% in 31 (12.1%) patients.
RESULTS
Median follow-up duration was 60.5 months (range: 6-202 months). Five-year locoregional control (LRC), disease-free survival (DFS), disease specific survival (DSS) and overall survival (OS) rates were 90.8%, 83.4%, 91.2%, and 85%, respectively. In multivariate analysis; bulky tumor (> 4 cm) was shown as an important prognostic factor for LRC, DFS and DSS. Pretreatment hemoglobin level (< 10 g/dl) was associated with lower OS rate. Endometrial involvement was associated with lower LRC and DFS. Treatment break > 14 days showed significance for DFS and DSS. MLNR was found as a valuable prognostic factor for all endpoints (LRC, DFS, DSS and OS). The rate of grade 3-4 late toxicity was 3.6% and 2%, respectively.
CONCLUSION
Postoperative RT/RCT is an effective treatment modality for early-stage cervical cancer patients with unfavorable features and provides satisfactory local control and survival rates with low morbidity.

Authors

Demirci S

Department of Radiation Oncology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey. senem.demirci@ege.edu.tr

Ozsaran Z

Ozsaran A

Yavas F

Demircioglu B

Hanhan M

Dikmen Y

Aras AB

Source

European journal of gynaecological oncology 33:1 2012 pg 62-7

MeSH

Adenocarcinoma
Adult
Aged
Antineoplastic Agents
Brachytherapy
Carcinoma, Squamous Cell
Chemoradiotherapy, Adjuvant
Cisplatin
Disease-Free Survival
Endometrium
Female
Follow-Up Studies
Hemoglobins
Humans
Kaplan-Meier Estimate
Lymphatic Metastasis
Middle Aged
Multivariate Analysis
Neoplasm Staging
Prognosis
Proportional Hazards Models
Radiotherapy, Adjuvant
Retrospective Studies
Uterine Cervical Neoplasms

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22439408