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Radical hysterectomy after radiotherapy for recurrent or persistent cervical cancer
Author(s) -
Mabuchi Seiji,
Kozasa Katsumi,
Kimura Tadashi
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12284
Subject(s) - medicine , adverse effect , cervical cancer , radical hysterectomy , hysterectomy , surgery , radiation therapy , retrospective cohort study , cancer
Objective To evaluate the safety and efficacy of radical hysterectomy after radiotherapy ( RH ‐ AR ) for recurrent or persistent cervical cancer. Methods The present retrospective study included patients who underwent RH ‐ AR for recurrent or persistent cervical cancer at Osaka University Hospital, Japan, between May 1, 2010 and September 30, 2016. Patient characteristics, intraoperative and postoperative adverse events, and surgical outcomes were investigated to identify patients at increased risk of recurrence or severe surgical adverse events. Results There were 31 patients scheduled for treatment with RH ‐ AR ; one hysterectomy procedure was aborted. No intraoperative adverse events or treatment‐related deaths occurred, and 8 (27%) patients experienced severe postoperative adverse events. After a median 34 months of follow‐up, 13 (43%) patients had developed recurrent disease, predominantly at distant sites. The estimated 3‐year overall survival rate was 53.8%. Positive surgical margins, nodal metastasis, parametrial invasion, and no adjuvant treatment after RH ‐ AR were found to be predictors of increased risk of recurrence. No predictors of severe surgical adverse events were identified. Conclusion RH ‐ AR was a safe, curative treatment for patients with recurrent or persistent cervical cancer. However, considering the significant risk of surgical adverse events, RH ‐ AR should only be performed for a select group of patients.