Isolated full-thickness cervical stromal invasion warrants post-hysterectomy pelvic radiotherapy in FIGO stages IB-IIA uterine cervical carcinoma

Sung Ho Moon, Hong Gyun Wu, Sung W. Ha, Hyo Pyo Lee, Soon Beom Kang, Yong Sang Song, Noh Hyun Park, Jae Won Kim, In Ae Park, Baek-Hui Kim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To evaluate the potential benefit of postoperative radiotherapy (PORT) in women with isolated full-thickness cervical stromal invasion (FTSI) as an unfavorable pathological finding after radical hysterectomy and pelvic lymph node dissection (PLND) in FIGO stages IB-IIA cervical carcinoma. Methods: A total of 1868 patients with stages IB-IIA cervical carcinoma underwent radical hysterectomy and PLND between January 1982 and December 2002. Seventy-four of these patients had isolated FTSI without any other unfavorable pathological finding, such as lymph node metastasis, microscopic parametrial involvement, involved resection margin, lympho-vascular space invasion, or large clinical tumor diameter (> 4 cm). Forty-one of these patients had no adjuvant treatment (S group) and 33 received PORT (PORT group). Patients with isolated FTSI who received chemotherapy were excluded. Treatment outcomes in the PORT and S groups were compared. Results: Ten-year disease-free survival (DFS) and pelvic-failure-free survival (PFFS) of S group vs. PORT group were 73.2% vs. 92.4% (P = 0.038) and 79.8% vs. 97.0% (P = 0.044), respectively. According to a Cox proportional hazards model developed by forward, stepwise regression incorporating all prognostic variables, only PORT was marginally significant for DFS (RR 0.234; 95% CI 0.051-1.067; P = 0.061) and significant for PFFS (RR 0.055; 95% CI 0.005-0.620; P = 0.019). A grade 4 late complication developed in two patients (6%) in PORT group. Conclusion: PORT administered to patients with isolated FTSI after radical hysterectomy and PLND improves pelvic control in FIGO stages IB-IIA cervical carcinoma with acceptable morbidity.

Original languageEnglish
Pages (from-to)152-157
Number of pages6
JournalGynecologic Oncology
Volume104
Issue number1
DOIs
Publication statusPublished - 2007 Jan 1
Externally publishedYes

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Hysterectomy
Radiotherapy
Carcinoma
Lymph Node Excision
Disease-Free Survival
Survival
Proportional Hazards Models
Blood Vessels
Lymph Nodes
Neoplasm Metastasis
Morbidity
Drug Therapy
Neoplasms

Keywords

  • Cervical cancer
  • Depth of invasion
  • Hysterectomy
  • Prognosis
  • Radiation

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

Isolated full-thickness cervical stromal invasion warrants post-hysterectomy pelvic radiotherapy in FIGO stages IB-IIA uterine cervical carcinoma. / Moon, Sung Ho; Wu, Hong Gyun; Ha, Sung W.; Lee, Hyo Pyo; Kang, Soon Beom; Song, Yong Sang; Park, Noh Hyun; Kim, Jae Won; Park, In Ae; Kim, Baek-Hui.

In: Gynecologic Oncology, Vol. 104, No. 1, 01.01.2007, p. 152-157.

Research output: Contribution to journalArticle

Moon, Sung Ho ; Wu, Hong Gyun ; Ha, Sung W. ; Lee, Hyo Pyo ; Kang, Soon Beom ; Song, Yong Sang ; Park, Noh Hyun ; Kim, Jae Won ; Park, In Ae ; Kim, Baek-Hui. / Isolated full-thickness cervical stromal invasion warrants post-hysterectomy pelvic radiotherapy in FIGO stages IB-IIA uterine cervical carcinoma. In: Gynecologic Oncology. 2007 ; Vol. 104, No. 1. pp. 152-157.
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abstract = "Objective: To evaluate the potential benefit of postoperative radiotherapy (PORT) in women with isolated full-thickness cervical stromal invasion (FTSI) as an unfavorable pathological finding after radical hysterectomy and pelvic lymph node dissection (PLND) in FIGO stages IB-IIA cervical carcinoma. Methods: A total of 1868 patients with stages IB-IIA cervical carcinoma underwent radical hysterectomy and PLND between January 1982 and December 2002. Seventy-four of these patients had isolated FTSI without any other unfavorable pathological finding, such as lymph node metastasis, microscopic parametrial involvement, involved resection margin, lympho-vascular space invasion, or large clinical tumor diameter (> 4 cm). Forty-one of these patients had no adjuvant treatment (S group) and 33 received PORT (PORT group). Patients with isolated FTSI who received chemotherapy were excluded. Treatment outcomes in the PORT and S groups were compared. Results: Ten-year disease-free survival (DFS) and pelvic-failure-free survival (PFFS) of S group vs. PORT group were 73.2{\%} vs. 92.4{\%} (P = 0.038) and 79.8{\%} vs. 97.0{\%} (P = 0.044), respectively. According to a Cox proportional hazards model developed by forward, stepwise regression incorporating all prognostic variables, only PORT was marginally significant for DFS (RR 0.234; 95{\%} CI 0.051-1.067; P = 0.061) and significant for PFFS (RR 0.055; 95{\%} CI 0.005-0.620; P = 0.019). A grade 4 late complication developed in two patients (6{\%}) in PORT group. Conclusion: PORT administered to patients with isolated FTSI after radical hysterectomy and PLND improves pelvic control in FIGO stages IB-IIA cervical carcinoma with acceptable morbidity.",
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T1 - Isolated full-thickness cervical stromal invasion warrants post-hysterectomy pelvic radiotherapy in FIGO stages IB-IIA uterine cervical carcinoma

AU - Moon, Sung Ho

AU - Wu, Hong Gyun

AU - Ha, Sung W.

AU - Lee, Hyo Pyo

AU - Kang, Soon Beom

AU - Song, Yong Sang

AU - Park, Noh Hyun

AU - Kim, Jae Won

AU - Park, In Ae

AU - Kim, Baek-Hui

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N2 - Objective: To evaluate the potential benefit of postoperative radiotherapy (PORT) in women with isolated full-thickness cervical stromal invasion (FTSI) as an unfavorable pathological finding after radical hysterectomy and pelvic lymph node dissection (PLND) in FIGO stages IB-IIA cervical carcinoma. Methods: A total of 1868 patients with stages IB-IIA cervical carcinoma underwent radical hysterectomy and PLND between January 1982 and December 2002. Seventy-four of these patients had isolated FTSI without any other unfavorable pathological finding, such as lymph node metastasis, microscopic parametrial involvement, involved resection margin, lympho-vascular space invasion, or large clinical tumor diameter (> 4 cm). Forty-one of these patients had no adjuvant treatment (S group) and 33 received PORT (PORT group). Patients with isolated FTSI who received chemotherapy were excluded. Treatment outcomes in the PORT and S groups were compared. Results: Ten-year disease-free survival (DFS) and pelvic-failure-free survival (PFFS) of S group vs. PORT group were 73.2% vs. 92.4% (P = 0.038) and 79.8% vs. 97.0% (P = 0.044), respectively. According to a Cox proportional hazards model developed by forward, stepwise regression incorporating all prognostic variables, only PORT was marginally significant for DFS (RR 0.234; 95% CI 0.051-1.067; P = 0.061) and significant for PFFS (RR 0.055; 95% CI 0.005-0.620; P = 0.019). A grade 4 late complication developed in two patients (6%) in PORT group. Conclusion: PORT administered to patients with isolated FTSI after radical hysterectomy and PLND improves pelvic control in FIGO stages IB-IIA cervical carcinoma with acceptable morbidity.

AB - Objective: To evaluate the potential benefit of postoperative radiotherapy (PORT) in women with isolated full-thickness cervical stromal invasion (FTSI) as an unfavorable pathological finding after radical hysterectomy and pelvic lymph node dissection (PLND) in FIGO stages IB-IIA cervical carcinoma. Methods: A total of 1868 patients with stages IB-IIA cervical carcinoma underwent radical hysterectomy and PLND between January 1982 and December 2002. Seventy-four of these patients had isolated FTSI without any other unfavorable pathological finding, such as lymph node metastasis, microscopic parametrial involvement, involved resection margin, lympho-vascular space invasion, or large clinical tumor diameter (> 4 cm). Forty-one of these patients had no adjuvant treatment (S group) and 33 received PORT (PORT group). Patients with isolated FTSI who received chemotherapy were excluded. Treatment outcomes in the PORT and S groups were compared. Results: Ten-year disease-free survival (DFS) and pelvic-failure-free survival (PFFS) of S group vs. PORT group were 73.2% vs. 92.4% (P = 0.038) and 79.8% vs. 97.0% (P = 0.044), respectively. According to a Cox proportional hazards model developed by forward, stepwise regression incorporating all prognostic variables, only PORT was marginally significant for DFS (RR 0.234; 95% CI 0.051-1.067; P = 0.061) and significant for PFFS (RR 0.055; 95% CI 0.005-0.620; P = 0.019). A grade 4 late complication developed in two patients (6%) in PORT group. Conclusion: PORT administered to patients with isolated FTSI after radical hysterectomy and PLND improves pelvic control in FIGO stages IB-IIA cervical carcinoma with acceptable morbidity.

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KW - Depth of invasion

KW - Hysterectomy

KW - Prognosis

KW - Radiation

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