title: Radical hysterectomy after chemoradiation in FIGO stage III cervical cancer patients versus chemoradiation and brachytherapy: Complications and 3-years survival.
abstract: BACKGROUND
  To compare patterns and rates of early and late complications, and survival outcome in FIGO stage III cervical cancer patients underwent to radical hysterectomy after chemo-radiation (CT-RT) vs. chemo-radiation alone.
  
  
  METHODS
  Between May 1996 and April 2013 150 FIGO stage III cervical cancer patients were treated. We divide patients according to type of treatment: 77 were submitted to standard treatment (Group A), and 73 to completion hysterectomy after chemo-radiation (Group B).
  
  
  RESULTS
  The baseline characteristics of the 2 groups were superimposable. We observed lower intra-operative and treatment-related early urinary and gastro-intestinal complications in Group B with respect to Group A (p < 0.001). Vascular complications were registered only in Group B (p < 0.001). We found a significantly higher rate of local recurrences in the Group A than in the Group B (p < 0.002). We registered 29 deaths in the Group A and 22 in the Group B (p = 0.021). The 3-years disease-free survival rate in the Group A and in the Group B was 62.9% and 68.3%, respectively (p = 0.686), and the 3-years overall survival rate in the Group A and in the Group B was 63.2% and 67.7%, respectively (p = 0.675).
  
  
  CONCLUSIONS
  This study confirms that radical hysterectomy after CT-RT is an effective therapeutic approach for advanced cervical cancer. Further prospective and randomized studies should be performed in order to solve the question about the standard approach, and how the different pattern of complication could impact on the quality of life.
authors.affiliation: Department of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, Italy. Electronic address: francesco.fanfani@unich.it.
authors.forename: F
authors.initials: F
authors.lastname: Fanfani
authors.affiliation: Department of Oncological Surgery, Gynecologic Oncologic Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Vizza
authors.affiliation: Department of Gynecology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Landoni
authors.affiliation: Gynecologic Oncology Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: P
authors.initials: P
authors.lastname: de Iaco
authors.affiliation: Department of Medicine and Health Sciences, University of Molise, Campobasso/Gynecologic Oncology Unit, Fondazione "Policlinico Universitario A. Gemelli", Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ferrandina
authors.affiliation: Department of Oncological Surgery, Gynecologic Oncologic Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Corrado
authors.affiliation: Division of Gynecologic Oncology, Department of Women and Child Health Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Gallotta
authors.affiliation: Department of Radiotherapy, "A. Gemelli" Hospital, Catholic University, Rome, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Gambacorta
authors.affiliation: Division of Gynecologic Oncology, Department of Women and Child Health Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Fagotti
authors.affiliation: Division of Gynecologic Oncology, Department of Women and Child Health Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Monterossi
authors.affiliation: Gynecologic Oncology Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: A M
authors.initials: AM
authors.lastname: Perrone
authors.affiliation: Division of Radiation Oncology, European Institute of Oncology, Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Lazzari
authors.affiliation: Division of Radiation Oncology, European Institute of Oncology, Milan, Italy.
authors.forename: S P
authors.initials: SP
authors.lastname: Colangione
authors.affiliation: Division of Gynecologic Oncology, Department of Women and Child Health Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects; D059248:Chemoradiotherapy / Q000009:adverse effects; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*
keywords: Cervical cancer; Chemoradiation; Radical hysterectomy