Randomized study between radical surgery and radiotherapy for the treatment of stage IB–IIA cervical cancer: 20-year update / 부인종양
Journal of Gynecologic Oncology
;
: e34-2017.
Article
in English
| WPRIM
| ID: wpr-96453
ABSTRACT
OBJECTIVE:
Stage IB–IIA cervical carcinoma can be equally cured either by radical surgery or radiotherapy (RT). Albeit such policies show the same efficacy, they carry a different morbidity. This is an update after 20 years of a previously published randomized trial of RT vs. surgery in the treatment of stage IB–IIA cervical cancers to assess long-term survival and morbidity and the different pattern of relapse between the 2 modalities.METHODS:
Between September 1986 and December 1991, women referred for a newly diagnosed stage IB and IIA cervical carcinoma were randomized to radical surgery or RT. The primary outcome measures were long-term survival and complications rate. The secondary outcome was recurrence of the disease.RESULTS:
Three-hundred forty-three eligible women were randomized 172 to radical surgery and 171 to external RT. Minimum follow-up was 19 years. Thirty-three patients (10%) died of intercurrent disease (31 cases) or fatal complications (2 cases). Twenty-year overall survival is 72% and 77% in the 2 treatment groups (p=0.280), respectively. As a whole, 94 recurrences (28%) were observed. Median time to relapse was 13.5 (surgery group) and 11.5 months (radiotherapy group) (p=0.100), respectively. Multivariate analysis confirms that risk factors for survival are histotype (p=0.020), tumor diameter (p=0.008), and lymph node status (p<0.001).CONCLUSION:
The results of the present study seem to suggest that there is no treatment of choice for early stage cervical carcinoma in terms of survival. Long term follow-up confirms that the best treatment for the individual patient should take into account clinical factors such as menopausal status, comorbidities, histological type, and tumor diameter.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Radiotherapy
/
Recurrence
/
Comorbidity
/
Uterine Cervical Neoplasms
/
Multivariate Analysis
/
Risk Factors
/
Follow-Up Studies
/
Outcome Assessment, Health Care
/
Lymph Nodes
Type of study:
Controlled clinical trial
/
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
Language:
English
Journal:
Journal of Gynecologic Oncology
Year:
2017
Type:
Article
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