Radical surgery with individualized postoperative radiation for stage ib cervical cancer; Oncologic outcomes and severe complications

Samith Sandadi, Edward J. Tanner, Fady Khoury-Collado, Alessandra Kostolias, Vicky Makker, Dennis S. Chi, Yukio Sonoda, Kaled M. Alektiar, Richard R. Barakat, Nadeem R. Abu-Rustum

Research output: Contribution to journalArticle

Abstract

Objective: The objective of this study was to compare morbidity and outcome following radical surgery with or without adjuvant radiation therapy (RT) in the treatment of stages IB1-IB2 cervical carcinoma. Methods: We retrospectively identified 222 patients with stages IB1-IB2 cervical carcinoma treated initially with radical hysterectomy or radical trachelectomy with or without adjuvant RT from February 2000 to November 2009. All grade 3 or higher complicationsVthose requiring interventional radiology, endoscopic evaluation, or operative interventionVwere documented. Results: One hundred fifty-eight patients (71%) underwent radical hysterectomy; 64 (29%) underwent radical trachelectomy. One hundred fifty-three patients (69%) underwent surgery alone; 69 (31%) received adjuvant radiation with or without chemosensitization. There was a statistically significant difference in the rate of total grades 1 to 5 late complications between the surgery-alone and surgery ± RT groups (12% vs 32%, respectively; P G 0.001); however, the rate of grade 3 or higher complications was similar (5% vs 4%, respectively; P = 0.999). The progression-free and overall survival rates of the entire cohort were both 95%. The 5-year progression-free survival rates for the surgery-alone and surgery ± RT groups were 93% and 90% (P = 0.172). The overall survival rates were 96% and 91%, respectively (P = 0.332). Conclusions: The majority of women with stages IB1-IB2 cervical cancer undergoing radical surgery do not require adjuvant RT, have excellent oncologic outcome, and have low severe complication rates. Nearly one third of our patients required postoperative radiation, with no statistically significant increase in severe complication rate and with similar oncologic outcomes compared with the surgery-only cohort. These data support the continued practice of radical surgery with individualized postoperative radiation for these patients.

Original languageEnglish (US)
Pages (from-to)553-558
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume23
Issue number3
DOIs
StatePublished - Mar 1 2013

Keywords

  • Cervical carcinoma IB
  • Complications
  • Radical surgery

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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    Sandadi, S., Tanner, E. J., Khoury-Collado, F., Kostolias, A., Makker, V., Chi, D. S., Sonoda, Y., Alektiar, K. M., Barakat, R. R., & Abu-Rustum, N. R. (2013). Radical surgery with individualized postoperative radiation for stage ib cervical cancer; Oncologic outcomes and severe complications. International Journal of Gynecological Cancer, 23(3), 553-558. https://doi.org/10.1097/IGC.0b013e3182849d53