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.
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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
Original language English
Type of outcome Article in a journal
Field of Study 30214 Obstetrics and gynaecology
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
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
Tags 14119612, rivok
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 12/2/2019 13:53.
Abstract
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.
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