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Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer.

Publication ,  Journal Article
Soisson, AP; Soper, JT; Clarke-Pearson, DL; Berchuck, A; Montana, G; Creasman, WT
Published in: Gynecol Oncol
June 1990

From 1971 through 1984, 320 women underwent radical hysterectomy as primary therapy of stage IB and IIA cervical cancer. Two hundred forty-eight patients (78%) were treated with surgery alone and 72 patients (22%) received adjuvant postoperative external-beam radiotherapy. Presence of lymph node metastasis, large lesion (greater than 4 cm in diameter), histologic grade, race (noncaucasian), and age (greater than 40 years) were significant poor prognostic factors for the entire group of patients. Patients treated with surgery alone had a better disease-free survival than those who received combination therapy (P less than 0.001). However, patients receiving adjuvant radiation therapy had a higher incidence of lymphatic metastases, tumor involvement of the surgical margin, and large cervical lesions. Adjuvant pelvic radiation therapy did not improve the survival of patients with unilateral nodal metastases or those who had a large cervical lesion with free surgical margins and the absence of nodal involvement. Radiation therapy appears to reduce the incidence of pelvic recurrences. Unfortunately, 84% of patients who developed recurrent tumor after combination therapy had a component of distant failure. The incidence of severe gastrointestinal or genitourinary tract complications was not different in the two treatment groups. However, the incidence of lymphedema was increased in patients who received adjuvant radiation therapy. Although adjuvant radiation therapy appears to be tolerated without a significant increase in serious complications, the extent to which it may improve local control rates and survival in high-risk patients appears to be limited. In view of the high incidence of distant metastases in high-risk patients, consideration should be given to adjuvant systemic chemotherapy in addition to radiation therapy.

Duke Scholars

Published In

Gynecol Oncol

DOI

ISSN

0090-8258

Publication Date

June 1990

Volume

37

Issue

3

Start / End Page

390 / 395

Location

United States

Related Subject Headings

  • Uterine Cervical Neoplasms
  • Survival Analysis
  • Radiation Injuries
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Lymphedema
  • Lymphatic Metastasis
  • Lymph Nodes
  • Hysterectomy
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Soisson, A. P., Soper, J. T., Clarke-Pearson, D. L., Berchuck, A., Montana, G., & Creasman, W. T. (1990). Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer. Gynecol Oncol, 37(3), 390–395. https://doi.org/10.1016/0090-8258(90)90374-t
Soisson, A. P., J. T. Soper, D. L. Clarke-Pearson, A. Berchuck, G. Montana, and W. T. Creasman. “Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer.Gynecol Oncol 37, no. 3 (June 1990): 390–95. https://doi.org/10.1016/0090-8258(90)90374-t.
Soisson AP, Soper JT, Clarke-Pearson DL, Berchuck A, Montana G, Creasman WT. Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer. Gynecol Oncol. 1990 Jun;37(3):390–5.
Soisson, A. P., et al. “Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer.Gynecol Oncol, vol. 37, no. 3, June 1990, pp. 390–95. Pubmed, doi:10.1016/0090-8258(90)90374-t.
Soisson AP, Soper JT, Clarke-Pearson DL, Berchuck A, Montana G, Creasman WT. Adjuvant radiotherapy following radical hysterectomy for patients with stage IB and IIA cervical cancer. Gynecol Oncol. 1990 Jun;37(3):390–395.
Journal cover image

Published In

Gynecol Oncol

DOI

ISSN

0090-8258

Publication Date

June 1990

Volume

37

Issue

3

Start / End Page

390 / 395

Location

United States

Related Subject Headings

  • Uterine Cervical Neoplasms
  • Survival Analysis
  • Radiation Injuries
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Lymphedema
  • Lymphatic Metastasis
  • Lymph Nodes
  • Hysterectomy