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

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.

Basic information

Original name

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

Authors

CIBULA, D. (203 Czech Republic, guarantor), N.R. ABU-RUSTUM (840 United States of America), D. FISCHEROVA (203 Czech Republic), S. PATHER (36 Australia), K. LAVIGNE (840 United States of America), J. SLAMA (203 Czech Republic), K. ALEKTIAR (840 United States of America), L. MING-YIN (36 Australia), R. KOCIAN (203 Czech Republic), A. GERMANOVA (203 Czech Republic), F. FRÜHAUF (203 Czech Republic), L. DOSTALEK (203 Czech Republic), Ladislav DUŠEK (203 Czech Republic, belonging to the institution) and K. NARAYAN (36 Australia)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30214 Obstetrics and gynaecology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 4.393

RIV identification code

RIV/00216224:14110/18:00104966

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.ygyno.2018.10.018

UT WoS

000456637800009

Keywords in English

lymph node negative cervical cancer

Abstract

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.

Citovat

CIBULA, D., N.R. ABU-RUSTUM, D. FISCHEROVA, S. PATHER, K. LAVIGNE, J. SLAMA, K. ALEKTIAR, L. MING-YIN, R. KOCIAN, A. GERMANOVA, F. FRÜHAUF, L. DOSTALEK, Ladislav DUŠEK and K. NARAYAN. Surgical treatment of “intermediate risk” lymph node negative cervical cancer patients without adjuvant radiotherapy – A retrospective cohort study and review of the literature. Gynecologic Oncology. San Diego: ACADEMIC PRESS INC ELSEVIER SCIENCE, 2018, vol. 151, No 3, p. 438-443. ISSN 0090-8258. Available from: https://dx.doi.org/10.1016/j.ygyno.2018.10.018.

@article{1479872,
   author = {Cibula, D. and AbuandRustum, N.R. and Fischerova, D. and Pather, S. and Lavigne, K. and Slama, J. and Alektiar, K. and MingandYin, L. and Kocian, R. and Germanova, A. and Frühauf, F. and Dostalek, L. and Dušek, Ladislav and Narayan, K.},
   article_location = {San Diego},
   article_number = {3},
   doi = {http://dx.doi.org/10.1016/j.ygyno.2018.10.018},
   keywords = {lymph node negative cervical cancer},
   language = {eng},
   issn = {0090-8258},
   journal = {Gynecologic Oncology},
   title = {Surgical treatment of “intermediate risk” lymph node negative cervical cancer patients without adjuvant radiotherapy – A retrospective cohort study and review of the literature},
   volume = {151},
   year = {2018}
}

TY  - JOUR
ID  - 1479872
AU  - Cibula, D. - Abu-Rustum, N.R. - Fischerova, D. - Pather, S. - Lavigne, K. - Slama, J. - Alektiar, K. - Ming-Yin, L. - Kocian, R. - Germanova, A. - Frühauf, F. - Dostalek, L. - Dušek, Ladislav - Narayan, K.
PY  - 2018
TI  - Surgical treatment of “intermediate risk” lymph node negative cervical cancer patients without adjuvant radiotherapy – A retrospective cohort study and review of the literature
JF  - Gynecologic Oncology
VL  - 151
IS  - 3
SP  - 438-443
EP  - 438-443
PB  - ACADEMIC PRESS INC ELSEVIER SCIENCE
SN  - 00908258
KW  - lymph node negative cervical cancer
N2  - 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.
ER  -

CIBULA, D., N.R. ABU-RUSTUM, D. FISCHEROVA, S. PATHER, K. LAVIGNE, J. SLAMA, K. ALEKTIAR, L. MING-YIN, R. KOCIAN, A. GERMANOVA, F. FRÜHAUF, L. DOSTALEK, Ladislav DUŠEK and K. NARAYAN. Surgical treatment of “intermediate risk” lymph node negative cervical cancer patients without adjuvant radiotherapy – A retrospective cohort study and review of the literature. \textit{Gynecologic Oncology}. San Diego: ACADEMIC PRESS INC ELSEVIER SCIENCE, 2018, vol.~151, No~3, p.~438-443. ISSN~0090-8258. Available from: https://dx.doi.org/10.1016/j.ygyno.2018.10.018.

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