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A retrospective comparison of outcome in IB2 and IIA cervical cancer patients treated with primary concurrent chemoradiation versus radical hysterectomy with or without tailored adjuvant therapy

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Author(s)
차순도조치흠권상훈신소진장태규
Alternative Author(s)
Cha, Soon DoCho, Chi HeumKwon, Sang HoonShin, So JinJang, Tae Kyu
Publication Year
2017
Keyword
HysterectomyConcurrent chemoradiotherapyCervical cancer
Abstract
Objective:

The aim of our study is to compare the overall survival (OS), progression-free survival (PFS), and treatment-related morbidities between primary concurrent chemoradiation therapy (CCRT) vs. radical hysterectomy (RH) with or without tailored adjuvant therapy in patients with stages IB2 and IIA cervical cancer.

Methods:

This was a retrospective study of 113 patients with IB2 or IIA cervical cancer treated with either primary CCRT (n=49) or RH (n=64) with or without tailored adjuvant therapy between 2002 and 2011 at Keimyung University Dongsan Medical Center. Patients in RH group was divided into those undergoing surgery alone (n=26) and those undergoing surgery with adjuvant therapy (n=38).

Results:

The median follow up period was 66 months. The 5-year OS by treatment modality was 88.7% for the 64 patients in the RH group and 72.8% for 49 patients in the CCRT group (P=0.044). The 5-year PFS was 82.3% and 65.6% after RH group and CCRT group (P=0.048), respectively. Grade 3-4 complication was less frequent after RH alone (7.7%) than RH with adjuvant therapy (34.2%) or CCRT group (28.6%) (P=0.047).

Conclusion:

The RH group seems to be superior to the CCRT group in oncologic outcomes. However, considering the selection bias including tumor size, lymph node meta, and parametrial invasion in pretreatment magnetic resonance imaging, both treatment modalities are reasonable and feasible in cervical cancer IB2 and IIA. It is important to choose the appropriate treatment modality considering the age and general condition of the patient. Randomized controlled study is needed to confirm the result of our study and determine the optimal treatment.
Department
Dept. of Obstetrics & Gynecology (산부인과학)
Publisher
School of Medicine (의과대학)
Citation
Obstetrics & Gynecology Science, Vol.60(6) : 549-557, 2017
Type
Article
ISSN
2287-8572
DOI
10.5468/ogs.2017.60.6.549
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/41046
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