Is Adjuvant Therapy Necessary for Patients with Intermediate-Risk Cervical Cancer after Open Radical Hysterectomy?
| Autor: | Hiroshi Yagi, Hideaki Yahata, Nobuko Yasutake, Kazuo Asanoma, Kaoru Okugawa, Keisuke Kodama, Tatsuhiro Ohgami, Kenzo Sonoda, Masafumi Yasunaga, Shusaku Inoue, Kiyoko Kato, Ichiro Onoyama, Eisuke Kaneki |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Uterine Cervical Neoplasms Disease Hysterectomy Risk Assessment Stromal Invasion 03 medical and health sciences 0302 clinical medicine Adjuvant therapy Medicine Humans Neoplasm Invasiveness 030212 general & internal medicine Postoperative Period Radical Hysterectomy Survival rate Aged Cervical cancer business.industry Cancer General Medicine Middle Aged medicine.disease Lymphovascular Surgery Oncology Chemotherapy Adjuvant 030220 oncology & carcinogenesis Female Neoplasm Recurrence Local business |
| Zdroj: | Oncology. 98(12) |
| ISSN: | 1423-0232 |
| Popis: | Introduction: Adjuvant therapy is usually recommended for patients with intermediate-risk cervical cancer (deep stromal invasion [DSI], lymphovascular space invasion [LVSI], and bulky tumor) after radical hysterectomy. However, we previously reported that DSI, LVSI, and bulky squamous cell carcinoma (SCC) were not correlated with prognosis in multivariate analysis; therefore, the indications we use for adjuvant therapy include complete stromal invasion, not DSI or LVSI or bulky SCC. The objective of this study was to evaluate the adequacy of our therapeutic strategy for cervical cancer after radical hysterectomy. Methods: We performed 321 type III open radical hysterectomies for cervical cancer between 2001 and 2013. Eighty-two patients with DSI, LVSI, or bulky SCC did not receive adjuvant therapy after radical hysterectomy under informed consent. We retrospectively evaluated the prognosis of these 82 patients. Results: Forty-two patients had >2/3 DSI and 35 patients had 1/3–2/3 DSI. Five patients had LVSI alone. The mean patient age was 43 years (range, 27–72). Six patients (7%) experienced recurrence during a median follow-up period of 84 months (range, 1–206). Two of the 6 patients with recurrence suffered cervical cancer-related deaths, but the remaining 4 cases are alive without evidence of disease after treatment during a follow-up period of 87–165 months. The 5-year disease-free survival rate was 92.6%, and the 5-year overall survival rate was 96.3%. Conclusions: Adjuvant therapy for DSI, LVSI, or bulky SCC after open radical hysterectomy might not be necessary. Further data collection is warranted to determine the standard of care for patients with intermediate-risk cervical cancer. |
| Databáze: | OpenAIRE |
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