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Impact of time interval between radical hysterectomy with pelvic node dissection and initial adjuvant therapy on oncological outcomes of early stage cervical cancer.
J Gynecol Oncol. 2017 Jul; 28(4):e42.JG

Abstract

OBJECTIVE

To determine the impact of time interval (TI) from radical hysterectomy with pelvic node dissection (RHND) to adjuvant therapy on oncological outcomes in cervical cancer.

METHODS

The study included 110 stage IA2-IB1 cervical cancer patients who underwent RHND and adjuvant therapy. The patients were divided into 2 groups based on the cut-off points of TI of 4 and 6 weeks, respectively. The associations of TI and clinicopathologic factors with oncological outcomes were evaluated using Cox proportional-hazards regression.

RESULTS

The median TI was 4.5 weeks. There were no statistical differences in 5-year recurrence-free survival (RFS) (89.2% vs. 81.0%, and 83.2% vs. 100.0%) or 5-year overall survival (OS) rates (90.9% vs. 97.2%, and 93.2% vs. 100.0%) between patients according to TI (≤4 vs. >4, and ≤6 vs. >6 weeks, respectively). Deep stromal invasion (p=0.037), and parametrial involvement (PI) (p=0.002) were identified as independent prognostic factors for RFS, together with the interaction between TI and squamous cell carcinoma histology (p<0.001). In patients with squamous cell carcinoma, a TI longer than 4 weeks was significantly associated with a worse RFS (hazard ratio [HR]=15.8; 95% confidence interval [CI]=1.4-173.9; p=0.024). Univariate analysis showed that only tumor size (p=0.023), and PI (p=0.003) were significantly associated with OS.

CONCLUSION

Delay in administering adjuvant therapy more than 4 weeks after RHND in early stage squamous cell cervical cancer results in poorer RFS.

Authors+Show Affiliations

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. hjitti@yahoo.com.Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28541633

Citation

Hanprasertpong, Jitti, et al. "Impact of Time Interval Between Radical Hysterectomy With Pelvic Node Dissection and Initial Adjuvant Therapy On Oncological Outcomes of Early Stage Cervical Cancer." Journal of Gynecologic Oncology, vol. 28, no. 4, 2017, pp. e42.
Hanprasertpong J, Jiamset I, Geater A, et al. Impact of time interval between radical hysterectomy with pelvic node dissection and initial adjuvant therapy on oncological outcomes of early stage cervical cancer. J Gynecol Oncol. 2017;28(4):e42.
Hanprasertpong, J., Jiamset, I., Geater, A., Leetanaporn, K., & Peerawong, T. (2017). Impact of time interval between radical hysterectomy with pelvic node dissection and initial adjuvant therapy on oncological outcomes of early stage cervical cancer. Journal of Gynecologic Oncology, 28(4), e42. https://doi.org/10.3802/jgo.2017.28.e42
Hanprasertpong J, et al. Impact of Time Interval Between Radical Hysterectomy With Pelvic Node Dissection and Initial Adjuvant Therapy On Oncological Outcomes of Early Stage Cervical Cancer. J Gynecol Oncol. 2017;28(4):e42. PubMed PMID: 28541633.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of time interval between radical hysterectomy with pelvic node dissection and initial adjuvant therapy on oncological outcomes of early stage cervical cancer. AU - Hanprasertpong,Jitti, AU - Jiamset,Ingporn, AU - Geater,Alan, AU - Leetanaporn,Kittinun, AU - Peerawong,Thanarpan, PY - 2017/01/24/received PY - 2017/03/05/revised PY - 2017/03/05/accepted PY - 2017/5/26/entrez PY - 2017/5/26/pubmed PY - 2018/1/5/medline KW - Adjuvant Chemoradiotherapy KW - Adjuvant Radiotherapy KW - Hysterectomy KW - Prognosis KW - Time Factor KW - Uterine Cervical Neoplasms SP - e42 EP - e42 JF - Journal of gynecologic oncology JO - J Gynecol Oncol VL - 28 IS - 4 N2 - OBJECTIVE: To determine the impact of time interval (TI) from radical hysterectomy with pelvic node dissection (RHND) to adjuvant therapy on oncological outcomes in cervical cancer. METHODS: The study included 110 stage IA2-IB1 cervical cancer patients who underwent RHND and adjuvant therapy. The patients were divided into 2 groups based on the cut-off points of TI of 4 and 6 weeks, respectively. The associations of TI and clinicopathologic factors with oncological outcomes were evaluated using Cox proportional-hazards regression. RESULTS: The median TI was 4.5 weeks. There were no statistical differences in 5-year recurrence-free survival (RFS) (89.2% vs. 81.0%, and 83.2% vs. 100.0%) or 5-year overall survival (OS) rates (90.9% vs. 97.2%, and 93.2% vs. 100.0%) between patients according to TI (≤4 vs. >4, and ≤6 vs. >6 weeks, respectively). Deep stromal invasion (p=0.037), and parametrial involvement (PI) (p=0.002) were identified as independent prognostic factors for RFS, together with the interaction between TI and squamous cell carcinoma histology (p<0.001). In patients with squamous cell carcinoma, a TI longer than 4 weeks was significantly associated with a worse RFS (hazard ratio [HR]=15.8; 95% confidence interval [CI]=1.4-173.9; p=0.024). Univariate analysis showed that only tumor size (p=0.023), and PI (p=0.003) were significantly associated with OS. CONCLUSION: Delay in administering adjuvant therapy more than 4 weeks after RHND in early stage squamous cell cervical cancer results in poorer RFS. SN - 2005-0399 UR - https://www.unboundmedicine.com/medline/citation/28541633/Impact_of_time_interval_between_radical_hysterectomy_with_pelvic_node_dissection_and_initial_adjuvant_therapy_on_oncological_outcomes_of_early_stage_cervical_cancer_ L2 - https://www.ejgo.org/DOIx.php?id=10.3802/jgo.2017.28.e42 DB - PRIME DP - Unbound Medicine ER -