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Bulky endocervical carcinoma: a 23-year experience
W W Thoms1, P J Eifel, T L Smith
1Division of Radiotherapy, University of Texas, M.D. Anderson Cancer Center, Houston 77030.
International Journal of Radiation Oncology, Biology, Physics
|January 11, 1992
Summary
This study on bulky endocervical cancer found that tumor size and lymph node status significantly impact survival. Treatment with radiation and hysterectomy showed better outcomes than radiation alone for advanced cases.
Area of Science:
- Gynecologic Oncology
- Radiation Oncology
- Surgical Oncology
Background:
- Bulky endocervical carcinomas pose treatment challenges.
- Tumor size and lymph node involvement are critical prognostic factors.
Purpose of the Study:
- To evaluate treatment outcomes for bulky endocervical cancer.
- To identify prognostic factors influencing survival and pelvic control.
Main Methods:
- Retrospective analysis of 371 patients with bulky endocervical cancer (≥6 cm).
- Comparison of survival and pelvic control rates based on tumor size, lymphangiography results, and treatment modality (radiation alone vs. radiation + hysterectomy).
Main Results:
- 5-year and 10-year actuarial survival rates were 54% and 48%, respectively.
- Tumor size ≥8 cm and positive lymphangiography were associated with significantly poorer survival.
- Patients treated with radiation + hysterectomy had better survival than those treated with radiation alone, though patient selection biases were noted.
Conclusions:
- Tumor size and lymph node status are key determinants of outcome in bulky endocervical cancer.
- While radiation + hysterectomy showed improved survival, careful patient selection is crucial.
- Further research is needed to clarify the independent role of adjuvant hysterectomy due to selection biases.