6533b824fe1ef96bd1281603
RESEARCH PRODUCT
Completion Surgery After Concomitant Chemoradiation in Locally Advanced Cervical Cancer: A Comprehensive Analysis of Pattern of Postoperative Complications
Alfredo ErcoliAlessio G. MorgantiGiovanni ScambiaAnna FagottiAlessandro Pasquale MargaritiGabriella FerrandinaFrancesco LeggeValerio GallottaGabriella MacchiaVito ChianteraFrancesco FanfaniVincenzo ValentiniMaria Giovanna Salernosubject
Malecervical cancermedicine.medical_treatmentUterine Cervical NeoplasmsPostoperative ComplicationsAntineoplastic Combined Chemotherapy Protocols80 and overlocally advanced cervical cancerAdjuvantSettore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIAAged 80 and overCervical cancerMedicine (all)Middle AgedPrognosisCombined Modality TherapyAdult; Aged; Aged; 80 and over; Antineoplastic Combined Chemotherapy Protocols; Carcinoma; Squamous Cell; Chemotherapy; Adjuvant; Cisplatin; Combined Modality Therapy; Female; Fluorouracil; Follow-Up Studies; Humans; Hysterectomy; Lymph Node Excision; Male; Middle Aged; Neoplasm Grading; Postoperative Complications; Prognosis; Radiotherapy; Adjuvant; Survival Rate; Uterine Cervical Neoplasms; Young AdultSurvival RateOncologyChemotherapy AdjuvantCarcinoma Squamous CellFemaleFluorouracilAdultmedicine.medical_specialtyGynecologic oncologyHysterectomyYoung AdultmedicineHumansChemotherapyRadical HysterectomyRadical surgeryconcomitant chemoradiationSurvival rateAgedHysterectomyRadiotherapybusiness.industryCarcinomamedicine.diseaseSurgerySettore MED/40 - GINECOLOGIA E OSTETRICIASquamous CellConcomitantLymph Node ExcisionRadiotherapy AdjuvantSurgeryLymphadenectomyCisplatinNeoplasm GradingbusinessFollow-Up Studiesdescription
Background: We provided a comprehensive analysis of rate, pattern, and severity of early and late postoperative complications in a very large, single-institution series of locally advanced cervical cancer (LACC) patients administered CT/RT plus radical surgery (RS). Methods: A total of 362 consecutive LACC (FIGO stage IB2-IVA) patients were submitted to RS after CT/RT at the Gynecologic Oncology Unit of the Catholic University (Rome/Campobasso). At 4 weeks after CT/RT, patients were evaluated for objective response and triaged to radical hysterectomy and pelvic ± aortic lymphadenectomy. Surgical morbidity was classified according to the Chassagne's grading system. Results: Most cases underwent type III-IV radical hysterectomy (N = 313, 86.5 %); pelvic lymphadenectomy was performed in all patients, while 116 patients (32.1 %) were also submitted to aortic lymphadenectomy. A total of 93 patients (25.7 %) experienced any grade postoperative complications, and 60 (16.6 %) had ≥grade 2 complications; grade 3-4 complications occurred in 21 patients (5.8 %). Of all early postoperative complications (N = 100), 31 (31.0 %) were urinary, 9 (9.0 %) were gastrointestinal, and 45 (45.0 %) were vascular. Of all late complications (N = 31), 20 (64.5 %) were urinary, 7 (22.6 %) gastrointestinal, and 2 (6.4 %) were vascular. Multivariate analysis showed that not complete clinical response to treatment retained an independent, unfavorable association with risk of development of postoperative morbidity, while advanced stage, and aortic lymphadenectomy showed only a borderline value. Conclusions: Failure to achieve clinical complete response to treatment and, to a lesser extent, more advanced stage, and aortic lymphadenectomy, were associated with a higher risk of developing any grade as well as ≥grade 2 complications. © 2014 Society of Surgical Oncology.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-01-01 | Annals of Surgical Oncology |