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

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Abstract

Background

We assessed the clinical outcome after hysterectomy in patients with bulky residual disease after chemoradiotherapy for stage IB2/II cervical carcinoma.

Methods

Subjects 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).

Results

Extrafascial 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.

Conclusions

This 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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Acknowledgments

The authors thank Lorna Saint Ange for editing.

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Authors and Affiliations

  1. Department of Surgery, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805, Villejuif, France

    Elie Azria MD, Philippe Morice MD, Anne Thoury MD & Damienne Castaigne MD

  2. Department of Radiation Therapy, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805, Villejuif, France

    Christine Haie-Meder MD

  3. Department of Medical Oncology, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805, Villejuif, France

    Patricia Pautier MD & Catherine Lhomme MD

  4. Departments of Pathology, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805, Villejuif, France

    Pierre Duvillard MD

Authors
  1. Elie Azria MD
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  2. Philippe Morice MD
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  3. Christine Haie-Meder MD
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  4. Anne Thoury MD
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  5. Patricia Pautier MD
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  6. Catherine Lhomme MD
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  7. Pierre Duvillard MD
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  8. Damienne Castaigne MD
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Corresponding author

Correspondence to Philippe Morice MD.

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Published by Springer Science+Business Media, Inc. © 2005 The Society of Surgical Oncology, Inc.

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Azria, E., Morice, P., Haie-Meder, C. et al. Results of Hysterectomy in Patients With Bulky Residual Disease at the End of Chemoradiotherapy for Stage IB2/II Cervical Carcinoma. Ann Surg Oncol 12, 332–337 (2005). https://doi.org/10.1245/ASO.2005.05.020

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  • DOI: https://doi.org/10.1245/ASO.2005.05.020

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