title: Predictive value of specimen histology after preoperative radiotherapy in the treatment of bulky/barrel carcinoma of the cervix.
abstract: One hundred thirty-four patients with bulky and barrel-shaped cervix cancers were treated with preoperative radiation to 40-45 Gy, intracavitary therapy using Cs-137 or Cf-252 and extrafascial total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) 4-6 weeks after radiotherapy. Outcome of therapy was traced for patients with residual tumor (positive) in the hysterectomy specimen and those who had no residual tumor (negative) in the specimens. All specimens were studied by a set protocol to carefully evaluate the TAHBSO specimen for gross or residual tumor. Ninety-two percent of the patients with negative specimens survived 5 years, but this dropped to 71% if the specimen was positive. These findings were observed in both the Cs-137- and Cf-252-treated patients. Patients with negative specimens failed mainly in distant sites, whereas those with positive specimens failed locally and distantly. Patient survival was less in patients with positive specimens. There was no difference in outcomes for adenocarcinoma and squamous cell carcinomas. The specimen histological findings have predictive value in patients treated with preoperative radiation and surgery.
authors.affiliation: Department of Radiation Medicine, University of Kentucky Medical Center, Lexington 40536-0084.
authors.forename: Y
authors.initials: Y
authors.lastname: Maruyama
authors.forename: J R
authors.initials: JR
authors.lastname: van Nagell
authors.forename: D
authors.initials: D
authors.lastname: Powell
authors.forename: J
authors.initials: J
authors.lastname: Yoneda
authors.forename: E
authors.initials: E
authors.lastname: Donaldson
authors.forename: H H
authors.initials: HH
authors.lastname: Gallion
authors.forename: R J
authors.initials: RJ
authors.lastname: Kryscio
mesh_terms: D000206:Actuarial Analysis; D000230:Adenocarcinoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery