Strahlentherapie und Onkologie

, Volume 174, Issue 10, pp 504–509 | Cite as

Adjuvant radiotherapy after radical hysterectomy of the cervical cancer

Prognostic factors and complications
  • Masashi Chatani
  • Takayuki Nose
  • Norie Masaki
  • Toshihiko Inoue
Originalarbeit

Abstract

Aim

To investigate prognostic factors and complications after radical hysterectomy followed by postoperative radiotherapy for carcinoma of the uterine cervix.

Patients and Methods

One hundred twenty-eight patients with Tlb-2b carcinoma of the uterine cervix following radical hysterectomy with bilateral pelvic lymphadenectomy and postoperative radiation therapy were reviewed. Pathologic and treatment variables were assessed by multivariate analysis for local recurrence, distant metastases and cause specific survival.

Results

The number of positive nodes (PN) in the pelvis was the strongest predictor of pelvic recurrence and distant metastases. These 2 failure patterns independently affect the cause specific survival. The 5-year cumulative local and distant failure were PN(0): 2% and 12%, PN(1–2): 23% and 25%, PN(2<): 32% and 57%, respectively (p=0.0029 and p=0.0051). The 5-year cause specific survival rates were PN(0): 90%, PN(1–2): 59% and PN(2<): 42% (p=0.0001). The most common complication was lymphedema of the foot experienced by one-half of the patients (5-year: 42%, 10-year: 49%).

Conclusion

These results suggest that patients with pathologic Tlb-T2b cervix cancer with pelvic lymph node metastases are at high risk of recurrence or metastases after radical hysterectomy with pelvic lymphadenectomy and postoperative irradiation.

Key Words

Postoperative radiotherapy Cervical cancer Prognostic factors 

Adjuvante Radiotherapie nach radikaler Hysterektomie bei Zervixkarzinom — Prognostische Faktoren und Komplikationen

Zusammenfassung

Ziel

Untersuchung der prognostischen Faktoren und Komplikationen der adjuvanten Radiotherapie nach radikaler Hysterektomie bei Patienten mit Zervixkarzinom.

Patienten und Methoden

In dieser Studie wurden 128 Patientinnen mit Zervixkarzinom untersucht, bei denen die pathologische Untersuchung nach radikaler Hysterektomie mit gleichzeitiger bilateraler pelvischer Lymphadenektomie und postoperativer Radiotherapie die Klassifikation als Tlb-T2b-Karzinome ergab. Dabei wurden pathologische und therapeutische Parameter auf der behandelten Seite mit Hilfe der Multivarianzanalyse auf lokale Rezidive und Fernmetastasen beeinflussende Faktoren hin untersucht.

Ergebnisse

Die Zahl der metastatischen pelvischen Lymphknoten (PN) war der wichtigste Indikator fur die Wahrscheinlichkeit für das Auftreten von lokalen Rezidiven und Fernmetastasen, wobei beide Parameter die Überlebensrate der Grundkrankheit fast unabhängig voneinander beeinflußten. Die kumulativen Fünf-Jahres-Raten für lokale Rezidive und Fernmetastasen waren jeweils bei PN(0): 2% und 12%, PN(1–2): 23% und 25% und PN(2<): 32% und 57% (p=0,0029 und p=0,0051). Die Fünf-Jahres-Überlebensraten für die Grundkrankheit waren jeweils bei PN(0): 90%, PN(1–2): 59%, PN(2<): 42% (p=0,0001). Die häufigste Komplikation waren Lymphödeme der Füße, die bei etwa der Hälfte der Patienten auftraten (fünf Jahre: 42%, zehn Jahre: 49%).

Schlußfolgerung en

Diese Ergebnisse deuten darauf hin, daß bei Patientinnen mit pathologisch als Tlb-T2b klassifizierten Zervixkarzinomen mit Lymphknotenmetastasen ein hohes Risiko von Rezidiven oder Metastasen nach radikaler Hysterektomie mit pelvischer Lymphadenektomie und postoperativer Bestrahlung besteht.

Schlüsselwörter

Postoperative Radiotherapie Zervixkarzinom Prognostische Faktoren 

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Copyright information

© Urban & Vogel 1998

Authors and Affiliations

  • Masashi Chatani
    • 1
  • Takayuki Nose
    • 1
  • Norie Masaki
    • 1
  • Toshihiko Inoue
    • 2
  1. 1.Department of Radiation TherapyOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  2. 2.Department of Radiation Oncology, Biomedical Research CenterOsaka University Medical SchoolOsakaJapan

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