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[Our 3-years experience in surgical management of cervical cancer]
Objectives:
To share our experience in surgical management of cervical cancer, combined adiotherapy (RT) and neoadjuvant chemotherapy (NCT) and to evaluate the 2-year overall and desease free survival, the incidance and sites of relapses.
Material:
One hundred eight cervical cancer patients, staged IB-IVB according to FIGO had been operated on by the author between the period XI. 2003-VI. 2006. Eighty one patients were evaluable for 2-year survival (follow-up ranging from 6 to 44 months, average - 25 months).
Methods:
Surgical management includes radical hysterectomy class II-IV, selective an pelvic and paraaortic lymph node dissection. Radiotherapy is preoperative 30-52 Gy adjuvant postoperative 52 Gy TGT Sixteen patients with positive lymph node metastases (LNM) were submitted to prophylactic field irradiation up to 46 Gy Cisplatin-based neoadjuvant chemotherapy had been administered 3 courses at intervals of 21 days before surgery.
Results:
Two-year overall survival is 95,1%, 2-year desease free survival (DFS)--90,1%, 2-year local control rate - 100%. The incidance rate of distant metastases is 9,9% (lungs--2,5%, liver--3,7%, bones--2,5%, vulva--1,2%). LNM are detected in 19,5% (IB1--14,5%, IB2--35,7%, IIA--11,1% stages), parametrial invasion--2,8% and metastases in ovaries--0,9%. Two-year DFS of patients with LNM is 84% and without LNM is 96,8%.
Conclusion:
Surgical management, combined with RT of above mentioned 108 patients leads to 100% 2-year local control rate. Two-year DFS of patients with LNM is 84%. NCD should to be administered concurrently or consecutively with RT in patients at high risk of distant relapses (11B, IB2 stages).
