Adjuvant hysterectomy for treatment of residual disease in patients with cervical cancer treated with radiation therapy

• Published in: British journal of cancer Vol. 99; no. 8; pp. 1216 - 1220
• Main Authors: Ota, T, Takeshima, N, Tabata, T, Hasumi, K, Takizawa, K
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 21-10-2008; Nature Publishing Group
• Subjects: Adult; Aged; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cervical cancer; Clinical Study; Combined Modality Therapy; Drug Resistance; Epidemiology; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Hysterectomy; Kaplan-Meier Estimate; Medical sciences; Middle Aged; Molecular Medicine; Neoplasm, Residual; Oncology; Postoperative Complications - epidemiology; Retrospective Studies; Tumors; Uterine Cervical Neoplasms - mortality; Uterine Cervical Neoplasms - radiotherapy; Uterine Cervical Neoplasms - surgery; radiation; residual disease; cervical carcinoma; hysterectomy; Human; Adjuvant treatment; Minimal residual disease; Malignant tumor; Hysterectomy; Radiotherapy; Female genital diseases; Cancerology; Surgery; Cervix carcinoma; Uterine cervix diseases; Cervical cancer; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6604619

The objective of this retrospective study was to determine the efficacy of adjuvant hysterectomy for treatment of residual disease in cervical carcinoma treated with radiation therapy. Between 1971 and 1996, 1590 patients with carcinoma of the uterine cervix (stages I–IIIb) were treated with radiation therapy. Three months after completion of radiation therapy, the status of local control was investigated, and total abdominal hysterectomy was performed in cases in which central residual disease existed in the cervix. Of the 1590 patients, residual disease was identified in 162 patients. Among these patients, 35 showed an absence of distant metastasis or lateral parametrial invasion and underwent hysterectomy. The overall 5- and 10-year survival rates for these patients were 68.6 and 65.7%, respectively. There was no significant difference in survival between patients with squamous cell carcinoma and those with non-squamous cell carcinoma or between patients with stage I/II carcinoma and those with stage III carcinoma. With respect to treatment-related morbidity, five (14.3%) patients suffered grade III or IV complications after hysterectomy. Adjuvant hysterectomy is an effective addition to radiation therapy in the treatment of cervical cancer, even in patients with stage III disease and in those with non-squamous cell carcinoma.