|Title:||Primary surgery versus primary radiation therapy for FIGO stages I-II small cell carcinoma of the uterine cervix: A retrospective Taiwanese Gynecologic Oncology Group study||Authors:||Chen T.-C.
|Issue Date:||2015||Journal Volume:||137||Journal Issue:||3||Start page/Pages:||468-473||Source:||Gynecologic Oncology||Abstract:||
Objective: To evaluate the role of surgery, radiation therapy and chemotherapy in the management of small cell carcinoma of the uterine cervix (SCCC) through a retrospective study of Taiwanese Gynecologic Oncology Group. Methods: We reviewed the medical records and histological files of 144 patients with FIGO stages IA-IIB SCCC treated in 11 main hospitals in Taiwan from 1987 to 2009. Results: There were 110 patients receiving primary surgery and 34 primary radiation therapy. Most patients in each group also received chemotherapy as part of primary treatment. A lower loco-regional failure rate was observed in patients who received primary radiation therapy than in those who had primary surgery (6% vs. 27%; P = 0.009). The 5-year overall survival (OS) was 89% for 13 surgically treated patients with cervical tumor ??2 cm and no lymphovascular space involvement (LVSI) in whom recurrence was noted in 2 of 4 patients without receiving adjuvant chemotherapy and none in the 9 patients who had chemotherapy. Excluding these 13 patients, primary radiation therapy with at least 5 cycles of platinum-based chemotherapy (n = 14, including 12 stages IB2-IIB) resulted in a 5-year OS of 78%, better than that of 46% by primary surgery (n = 97, including 40 stages IB2-IIB) (P = 0.046). Conclusions: None of the 9 patients with cervical tumor 2 cm and no LVSI showed disease recurrence after primary surgery and adjuvant chemotherapy. For most patients with stages I-II, primary radiation therapy with aggressive chemotherapy was associated with better survival than surgery. ? 2015 Elsevier Inc. All rights reserved.
|URI:||https://scholars.lib.ntu.edu.tw/handle/123456789/452906||DOI:||10.1016/j.ygyno.2015.03.015||SDG/Keyword:||cisplatin; etoposide; fluorouracil; adult; aged; brachytherapy; cancer adjuvant therapy; cancer chemotherapy; cancer growth; cancer radiotherapy; cancer recurrence; cancer size; cancer surgery; cause of death; clinical feature; cohort analysis; failure free survival; female; follow up; histopathology; human; human tissue; hysterectomy; lymph node dissection; lymph node metastasis; major clinical study; medical record review; outcome assessment; overall survival; postoperative period; priority journal; radical hysterectomy; Review; sepsis; small cell carcinoma; treatment failure; uterine cervix biopsy; uterine cervix carcinoma; uterine cervix small cell carcinoma; very elderly; cancer staging; Carcinoma, Small Cell; disease free survival; middle aged; pathology; retrospective study; Taiwan; Uterine Cervical Neoplasms; Adult; Aged; Aged, 80 and over; Carcinoma, Small Cell; Cohort Studies; Disease-Free Survival; Female; Humans; Middle Aged; Neoplasm Staging; Retrospective Studies; Taiwan; Uterine Cervical Neoplasms
|Appears in Collections:||醫學系|
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