[Our 3-years experience in surgical management of cervical cancer].
OBJECTIVE
To share our experience in surgical management of cervical cancer, combined adiotherapy (RT) and neoadjuvant chemotherapy (NCT) and to evaluate the 2-year overall and desease free survival, the incidance and sites of relapses.


METHODS
One hundred eight cervical cancer patients, staged IB-IVB according to FIGO had been operated on by the author between the period XI. 2003-VI. 2006. Eighty one patients were evaluable for 2-year survival (follow-up ranging from 6 to 44 months, average - 25 months).


METHODS
Surgical management includes radical hysterectomy class II-IV, selective an pelvic and paraaortic lymph node dissection. Radiotherapy is preoperative 30-52 Gy adjuvant postoperative 52 Gy TGT Sixteen patients with positive lymph node metastases (LNM) were submitted to prophylactic field irradiation up to 46 Gy Cisplatin-based neoadjuvant chemotherapy had been administered 3 courses at intervals of 21 days before surgery.


RESULTS
Two-year overall survival is 95,1%, 2-year desease free survival (DFS)--90,1%, 2-year local control rate - 100%. The incidance rate of distant metastases is 9,9% (lungs--2,5%, liver--3,7%, bones--2,5%, vulva--1,2%). LNM are detected in 19,5% (IB1--14,5%, IB2--35,7%, IIA--11,1% stages), parametrial invasion--2,8% and metastases in ovaries--0,9%. Two-year DFS of patients with LNM is 84% and without LNM is 96,8%.


CONCLUSIONS
Surgical management, combined with RT of above mentioned 108 patients leads to 100% 2-year local control rate. Two-year DFS of patients with LNM is 84%. NCD should to be administered concurrently or consecutively with RT in patients at high risk of distant relapses (11B, IB2 stages).
Kornovski
Ia
Ia
Ianeva
R
R
Filev
S
S
Mladenov
O
O
Uzunov
S
S
D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*