Node-positive cervical cancer: Impact of pelvic irradiation and patterns of failure

Adjuvant radiotherapy after radical hysterectomy of the cervical cancer

“…The pelvic recurrence rates for the surgery group (67%) versus the combined group (27%) were significant although the 5-year survival rates for the surgery group (72%) versus the combined group (64%) were not significant. Stock et al [18] also reported that postoperative pelvic irradiation versus surgery alone significantly improves pelvic control, i. e., the combined group 78% versus the surgery group 45% (p = 0.0004), disease-free survival 65% versus 41% (p = 0.0004), and overall survival 58% versus 46% (p = 0.02), respectively.…”

“…Whole pelvic irradiation attempts to improve survival for these patients, and the benefit of such therapy is demonstrated by several studies [4,18]. The purpose of this study is to evaluate the prognostic factors for local control and survival in patients with carcinoma of the uterine cervix after radical hysterectomy and postoperative radiotherapy.…”

Therapeutic Outcome and Prognostic Factors in the Radiotherapy of Recurrences of Cervical Carcinoma Following Surgery

“…Eleven of the 26 patients in our study had prognostic high risk factors in the primary situation but had not undergone postoperative pelvic irradiation for various reasons. Adjuvant radiotherapy in case of risk factors has been the usual clinical practice for early cervical carcinoma in many departments [2,12,19,33,39,45]. Many authors emphasize the value and necessity of adjuvant treatment in patients with high risk factors [4,20,26,37] like positive pelvic lymph nodes, parametric involvement, positive margins, lymph-or hemangiosis, bulky tumors, deep invasion of cervical stroma, or histology of adenocarcinoma, clear-cell or small-cell carcinoma [1,3,7,10,15,16,27,31,34].…”

Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer

“…Several reports have shown predictors for the survival of patients with lymph node metastasis determined by multivariate analysis (Table 6). 9,[63][64][65] The Gynecologic Oncology Group/Southwest Oncology Group/Radiation Therapy Oncology Group (GOG 109/ SWOG 8797/RTOG 91-12) clinical trial evaluated patients with positive pelvic lymph nodes and/or microscopic involvement of the parametrium and/or positive surgical margins, who were randomly allocated to receive either pelvic radiotherapy alone or radiotherapy in combination with chemotherapy (cisplatin + 5-fl uorouracil ). 88 The results demonstrated that progression-free and overall survivals were signifi cantly improved with the addition of chemotherapy.…”