title: Postoperative radiotherapy following inadvertent simple hysterectomy versus radical hysterectomy for cervical carcinoma.
abstract: OBJECTIVE
  For cervical carcinoma, postoperative radiation therapy (PORT) following radical hysterectomy (RH) is indicated for certain adverse pathological factors. Simple hysterectomy (SH) is considered inadequate treatment for invasive cervical carcinoma and PORT is required for all such cases. Clinical outcome of patients receiving PORT following SH and RH may be different. The aim of our retrospective study is to compare the results of PORT following inadvertent SH or RH in cervical carcinoma.
  
  
  METHODS
  During years 2003-2005, we treated 83 patients with cervical carcinoma with PORT following either SH (Group SH, 33 patients) or RH (Group RH, 50 patients). All patients were treated with pelvic external beam radiation therapy (EBRT) followed by intravaginal brachytherapy (IVBT). The endpoints of the study were local control, recurrence free survival (RFS) and delayed complications.
  
  
  RESULTS
  Median follow period up was 34 months (range 2-75 months). Local control rate observed in Gp SH and RH was 70% and 88% respectively with a p value of <0.05. Cumulative 5-year overall survival (OS) for combined group was 62%. Group RH patients had significantly better 5-year RFS than Group SH patients (72% and 49% respectively; p value 0.04). The frequency of Grade III-IV toxicity (bladder, rectum, and bowel) in Group SH versus Group RH was 6% vs 8% respectively (p value 0.1). The pedal lymph edema was higher in Group RH patients (10% vs 3%, p value<0.05).
  
  
  CONCLUSIONS
  PORT provides greater clinical benefit in patients who had undergone RH than SH for early stage invasive cervical carcinoma.
authors: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India. sharmadn@hotmail.com
authors: Daya Nand
authors: DN
authors: Sharma
authors: Goura Kisor
authors: GK
authors: Rath
authors: Sunesh
authors: S
authors: Kumar
authors: Neerja
authors: N
authors: Bhatla
authors: Ajeet Kumar
authors: AK
authors: Gandhi
authors: Piyush
authors: P
authors: Sharma
authors: Subhash
authors: S
authors: Gupta
authors: Parmod Kumar
authors: PK
authors: Julka
mesh_terms: D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy; D053208:Kaplan-Meier Estimate; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*