Exenteração pélvica para câncer do colo uterino recidivado pós-radioterapia: experiência de um centro terciário do Nordeste brasileiro

Abstract

PURPOSE: to analyze complications, morbidity, mortality and survival rate in a group of patients with cervical cancer with central pelvic relapse after primary radiotherapy treatment. METHODS: retrospective study of a series of 16 cases of pelvic exenteration after primary radiotherapy treatment. Descriptive statistics, survival curve through Kaplan-Meier's method, and regression analysis to evaluate prognosis were performed. RESULTS: sixteen patients have undergone pelvic exenteration. Epidermoid carcinoma, IIb stage and undifferentiated grade were the most frequent conditions. Post-operatory tumor relapse occurred in half the cases. Eleven patients presented peri or post-surgical complications, the most frequent being pelvic infection, that of the surgical wound, and urinary fistulae. Global survival rate was 64.3%, with average follow-up of 11 months. Regression analysis did not detect any significant prognosis factor for the patient survival. CONCLUSIONS: the survival rate was 64.3%. No particular factor associated to poor prognosis has been found in the present series of cases.

Carcinoma do colo do útero: taxa de sobrevida e fatores prognósticos em mulheres no Estado de Mato Grosso

“…The rate of women who had received chemotherapy was 62.6% (4) ; that of those who underwent brachytherapy, 65.3% (5) ; and that of those who underwent pelvic exenteration after primary radiotherapy treatment, 64.3% (6) . Probably, these differences are more closely associated with the extent of the disease, which determines the type of treatment.…”

Positron emission tomography/computerised tomography imaging in detecting and managing recurrent cervical cancer: systematic review of evidence, elicitation of subjective probabilities and economic modelling

“…The best-quality RCT found compared cisplatin with no cisplatin with both groups receiving radiotherapy, 127 which gave an overall 5-year survival with cisplatin of 63% and without cisplatin of 59%. Only case series were found on radiotherapy (nine studies [84][85][86][87][88][89][90][91][92] ), chemoradiotherapy (seven studies [93][94][95][96][97][98][99] ), radical hysterectomy (seven studies [100][101][102][103][104][105][106] ) and pelvic exenteration (20 studies [107][108][109][110][111][112][113][114][115][116][117][118][119][120][121][122][123][124][125][126] ). The survival rates varied considerably, depending on the date of publication, characteristics of patients and type of treatment given.…”

Health technology assessment

“…Twenty case series, [107][108][109][110][111][112][113][114][115][116][117][118][119][120][121][122][123][124][125][126] published between 1953 and 2009, presented results on pelvic exenteration, mostly from the USA (Table 49). The number of patients varied between 14 and 263.…”

“…The best-quality RCT found compared cisplatin with no cisplatin with both groups receiving radiotherapy, 127 which gave an overall 5-year survival with cisplatin of 63% and without cisplatin of 59%. Only case series were found on radiotherapy (nine studies [84][85][86][87][88][89][90][91][92] ), chemoradiotherapy (seven studies [93][94][95][96][97][98][99] ), radical hysterectomy (seven studies [100][101][102][103][104][105][106] ) and pelvic exenteration (20 studies [107][108][109][110][111][112][113][114][115][116][117][118][119][120][121][122][123][124][125][126] ). The survival rates varied considerably, depending on the date of publication, characteristics of patients and type of treatment given.…”