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Results of Hysterectomy in Patients With Bulky Residual Disease at the End of Chemoradiotherapy for Stage IB2/II Cervical Carcinoma

Authors
  • Azria, Elie1
  • Morice, Philippe1
  • Haie-Meder, Christine2
  • Thoury, Anne1
  • Pautier, Patricia3
  • Lhomme, Catherine3
  • Duvillard, Pierre4
  • Castaigne, Damienne1
  • 1 Institut Gustave Roussy, Department of Surgery, 39 Rue Camille Desmoulins, Villejuif, 94805, France
  • 2 Institut Gustave Roussy, Department of Radiation Therapy, 39 Rue Camille Desmoulins, Villejuif, 94805, France
  • 3 Institut Gustave Roussy, Department of Medical Oncology, 39 Rue Camille Desmoulins, Villejuif, 94805, France
  • 4 Institut Gustave Roussy, Departments of Pathology, 39 Rue Camille Desmoulins, Villejuif, 94805, France
Type
Published Article
Journal
Annals of Surgical Oncology
Publisher
Springer - Society of Surgical Oncology
Publication Date
Mar 14, 2005
Volume
12
Issue
4
Pages
332–337
Identifiers
DOI: 10.1245/ASO.2005.05.020
Source
Springer Nature
Keywords
License
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Abstract

BackgroundWe assessed the clinical outcome after hysterectomy in patients with bulky residual disease after chemoradiotherapy for stage IB2/II cervical carcinoma.MethodsSubjects were 10 patients who had bulky (>2 cm) residual disease in the cervix after external radiotherapy (45 Gy) combined with concomitant chemotherapy (cisplatin 40 mg/m2/week) and uterovaginal brachytherapy (15 Gy).ResultsExtrafascial hysterectomy was performed in three patients, type II radical hysterectomy was performed in six patients, and pelvic exenteration was performed in one patient. Pelvic lymphadenectomy was performed in eight patients, and para-aortic lymphadenectomy was performed in eight. Five patients had nodal involvement (pelvic nodes in four and para-aortic nodes in four), and six had lymphovascular space involvement. Surgical margins were free in nine patients. Seven patients developed grade 2 (n = 3) and/or grade 3 (n = 4) complications. The median duration of follow-up after surgery was 22 months (range, 1–37 months). With follow-up available in nine patients, seven relapsed, and only two remained disease free.ConclusionsThis series confirms the high rate of nodal spread in patients with bulky residual cervical disease after chemoradiotherapy. Furthermore, patients who underwent hysterectomy had a high complication rate. Only two patients are alive and disease free. The results of surgery are disappointing; surgery does not seem to improve the survival of these patients.

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