Posttherapy residual disease associates with long-term survival after chemoradiation for bulky stage 1B cervical carcinoma: a Gynecologic Oncology Group study

Objective The objective of the study was to study posttherapy chemoradiation hysterectomy histology with long-term survival in bulky stage 1B cervical cancer patients. Study Design Gynecologic Oncology Group protocols 71 and 123 enrolled 464 patients randomly allocated to pelvic radiation (75 Gy, n...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2010-10, Vol.203 (4), p.351.e1-351.e8
Main Authors: Kunos, Charles, MD, PhD, Ali, Shamshad, MA, Abdul-Karim, Fadi W., MD, Stehman, Frederick B., MD, Waggoner, Steven, MD
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antineoplastic Agents - therapeutic use
Biological and medical sciences
Carcinoma - mortality
Carcinoma - pathology
Carcinoma - therapy
Chemotherapy, Adjuvant
Cisplatin - therapeutic use
Disease Progression
Female
Female genital diseases
Gynecology. Andrology. Obstetrics
Humans
Hysterectomy
Medical sciences
Middle Aged
Neoplasm Recurrence, Local
Neoplasm, Residual
Obstetrics and Gynecology
Radiotherapy, Adjuvant
Retrospective Studies
Tumors
Uterine Cervical Neoplasms - mortality
Uterine Cervical Neoplasms - pathology
Uterine Cervical Neoplasms - therapy
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Summary:Objective The objective of the study was to study posttherapy chemoradiation hysterectomy histology with long-term survival in bulky stage 1B cervical cancer patients. Study Design Gynecologic Oncology Group protocols 71 and 123 enrolled 464 patients randomly allocated to pelvic radiation (75 Gy, n = 291) plus hysterectomy (RTH) or to pelvic radiation (75 Gy) and cisplatin (40 mg/m2 , n = 176) plus hysterectomy (RTCH). Risk of progression and death were evaluated by posttherapy hysterectomy response (good: .47). Poor response patients after RTCH had superior OS ( P = .046) and PFS ( P = .084). Extrapelvic recurrences occurred more often in poor response patients. Conclusion Posttherapy viable residual disease less than 10% was associated with reduced risk of progression and cancer-related death.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2010.05.005