J 2018

Surgical treatment of “intermediate risk” lymph node negative cervical cancer patients without adjuvant radiotherapy – A retrospective cohort study and review of the literature

CIBULA, D., N.R. ABU-RUSTUM, D. FISCHEROVA, S. PATHER, K. LAVIGNE et. al.

Základní údaje

Originální název

Surgical treatment of “intermediate risk” lymph node negative cervical cancer patients without adjuvant radiotherapy – A retrospective cohort study and review of the literature

Autoři

CIBULA, D. (203 Česká republika, garant), N.R. ABU-RUSTUM (840 Spojené státy), D. FISCHEROVA (203 Česká republika), S. PATHER (36 Austrálie), K. LAVIGNE (840 Spojené státy), J. SLAMA (203 Česká republika), K. ALEKTIAR (840 Spojené státy), L. MING-YIN (36 Austrálie), R. KOCIAN (203 Česká republika), A. GERMANOVA (203 Česká republika), F. FRÜHAUF (203 Česká republika), L. DOSTALEK (203 Česká republika), Ladislav DUŠEK (203 Česká republika, domácí) a K. NARAYAN (36 Austrálie)

Vydání

Gynecologic Oncology, San Diego, ACADEMIC PRESS INC ELSEVIER SCIENCE, 2018, 0090-8258

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30214 Obstetrics and gynaecology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 4.393

Kód RIV

RIV/00216224:14110/18:00104966

Organizační jednotka

Lékařská fakulta

UT WoS

000456637800009

Klíčová slova anglicky

lymph node negative cervical cancer

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 12. 2. 2019 13:53, Soňa Böhmová

Anotace

V originále

Objectives. The role of adjuvant radiotherapy for lymph node-negative stage IB patients with tumor-related negative prognostic factors is not uniformly accepted. It is advocated based on the GOG 92 trial, which was initiated in 1989. The aim of the current study is to report the oncological outcome of "intermediate risk" patients treated by tailored surgery without adjuvant radiotherapy. Data from two institutions that refer these patients for adjuvant radiotherapy served as a control group. Methods. Included were patients with stage IB cervical cancer treated with radical hysterectomy and pelvic lymphadenectomy, who had negative pelvic lymph nodes but a combination of negative prognostic factors adopted from the GOG 92 trial. Data were obtained from prospectively collected databases of three institutions. Radical surgery was a single-treatment modality in one of them and in the remaining two institutes it was followed by adjuvant chemoradiation. Results. In 127 patients who received only radical surgery, with a median follow-up of 6.1 years, the local recurrence rate was 1.6% (2 cases), and total recurrence was 6.3% (8 cases). Disease-specific survival at 5 years was 95.7% (91.9%: 99.4%) and 91% (83.7%; 98.3%) at 10 years. The only significant factor for disease-specific survival was tumor size >= 4 cm (P = 0.032). The recurrence rate, local control or overall survival did not differ from the control group. Adjuvant radiotherapy was not a significant prognostic factor within the whole cohort. Conclusions. An excellent oncological outcome, especially local control, can be achieved by both radical surgery or combined treatment in stage IB lymph node-negative cervical cancer patients with negative prognostic factors. The substantially better outcome than in the GOG 92 trial can be attributed to more accurate pre-operative and pathological staging and an improvement in surgical techniques.