title: [Surgery alone or in association with preoperative uterovaginal brachytherapy for stage IB1 cervical cancer: Toxicities profiles].
abstract: OBJECTIVE
  To assess toxicity profile in two stage-IB1 cervical cancer treatment strategies: surgery with and without preoperative uterovaginal pulsed dose-rate brachytherapy.
  
  
  METHODS
  A retrospective study included 45 patients presenting stage-IB1 cervical cancer without pelvic lymph-node invasion, between 2009 and 2011: 25 treated by colpohysterectomy alone (group A) and 20 with preoperative uterovaginal pulsed dose-rate brachytherapy (group B). The median follow-up was 45 and 39 months (group A and B).
  
  
  RESULTS
  Groups were comparable for age (median, 46.9 vs 47.6 years), histologic type (52% vs 65% squamous cell carcinoma) and tumor size (68% vs 60%, <2cm). In postoperative year 1, rates of urinary, digestive and gynaecological disorder were 39.1%, 8.7% and 15% respectively in group A versus 36.8%, 5.3% and 31.6% in group B and in year 2, 5.9%, 8.4% and 15% versus 5.6%, 5.1% and 27.8%.
  
  
  CONCLUSIONS
  The present study comparing two stage-IB1 cervical cancer treatment strategies found no significant difference in early or late complications. In 2 months, there was greater grade-3 urinary toxicity (21.1%) and sexual disorder (15.8%) with preoperative brachytherapy but no significant difference. Exclusive surgery is probably preferable for the patient's quality of life.
authors.affiliation: Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France. Electronic address: gery.lamblin@chu-lyon.fr.
authors.forename: G
authors.initials: G
authors.lastname: Lamblin
authors.affiliation: Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France.
authors.forename: M
authors.initials: M
authors.lastname: Rouffiac
authors.affiliation: Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France.
authors.forename: P
authors.initials: P
authors.lastname: Mathevet
authors.affiliation: Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France.
authors.forename: E
authors.initials: E
authors.lastname: Martin
authors.affiliation: Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France.
authors.forename: K
authors.initials: K
authors.lastname: Peignaux-Casasnovas
authors.affiliation: Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France.
authors.forename: P
authors.initials: P
authors.lastname: Chabert
authors.affiliation: Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France.
authors.forename: K
authors.initials: K
authors.lastname: Lebail-Carval
authors.affiliation: Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France.
authors.forename: G
authors.initials: G
authors.lastname: Chene
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology*; D011300:Preoperative Care / Q000379:methods; D011788:Quality of Life; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*
keywords: 3D dosimetry; Cancer du col de l’utérus; Complications postopératoires; Curiethérapie pulsée; Dosimétrie en trois dimensions; Early-stage cervical cancer; Hystérectomie élargie; Morbidity; Morbidité; Pulsed dose-rate brachytherapy; Radical hysterectomy; Toxicity