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Prognostic analysis of uterine cervical cancer treated with postoperative radiotherapy: Importance of positive or close parametrial resection margin

Title
Prognostic analysis of uterine cervical cancer treated with postoperative radiotherapy: Importance of positive or close parametrial resection margin
Authors
Kim Y.-J.Lee K.-J.Park K.R.Kim J.Jung W.Lee R.Kim S.C.Moon H.S.Ju W.Kim Y.H.Lee J.
Ewha Authors
김승철문혜성이레나주웅김윤환박경란
SCOPUS Author ID
김승철scopus; 문혜성scopus; 이레나scopus; 주웅scopus; 김윤환scopus; 박경란scopus
Issue Date
2015
Journal Title
Radiation Oncology Journal
ISSN
2234-1900JCR Link
Citation
vol. 33, no. 2, pp. 109 - 116
Keywords
Parametrial resection marginPostoperative adjuvant radiotherapyUterine cervical neoplasms
Publisher
Department of Radiation Oncology
Indexed
SCOPUS scopus
Abstract
Purpose: To analyze prognostic factors for locoregional recurrence (LRR), distant metastasis (DM), and overall survival (OS) in cervical cancer patients who underwent radical hysterectomy followed by postoperative radiotherapy (PORT) in a single institute. Materials and Methods: Clinicopathologic data of 135 patients with clinical stage IA2 to IIA2 cervical cancer treated with PORT from 2001 to 2012 were reviewed, retrospectively. Postoperative parametrial resection margin (PRM) and vaginal resection margin (VRM) were investigated separately. The median treatment dosage of external beam radiotherapy (EBRT) to the whole pelvis was 50.4 Gy in 1.8 Gy/fraction. High-dose-rate vaginal brachytherapy after EBRT was given to patients with positive or close VRMs. Concurrent platinum-based chemoradiotherapy (CCRT) was administered to 73 patients with positive resection margin, lymph node (LN) metastasis, or direct extension of parametrium. Kaplan-Meier method and log-rank test were used for analyzing LRR, DM, and OS; Cox regression was applied to analyze prognostic factors. Results: The 5-year disease-free survival was 79% and 5-year OS was 91%. In univariate analysis, positive or close PRM, LN metastasis, direct extension of parametrium, lymphovascular invasion, histology of adenocarcinoma, and chemotherapy were related with more DM and poor OS. In multivariate analysis, PRM and LN metastasis remained independent prognostic factors for OS. Conclusion: PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study. Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT. Therefore, additional treatments to improve local control such as radiation boosting need to be considered. © 2015. The Korean Society for Radiation Oncology.
DOI
10.3857/roj.2015.33.2.109
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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