1177 Prognostic value of histological tumor regression after irradiation for uterine cervix carcinoma

Abstract

Radio-surgical combination is an effective treatment for centro pelvic cervix carcinoma. Using preoperative radiotherapy, 80% of the patients have no residual disease at the time of surgery. The purpose of this study was to determine the prognostic value of the cervix sterilization after initial irradiation. Patients and methods Between 1976 and 1993, 200 patients with histologically proven cervix carcinoma (91 patients with clinical stage Ib tumor, 91 with stage IIA, and 18 with stage IIB) have been treated by irradiation followed by radical hysterectomy 6 weeks later. The mean age was 48 years. Median follow up was 86 months. One hundred and five patients underwent an utero-vaginal application of caesium 137. A dose of 60 Gy was delivered in the reference volume followed by radical hysterectomy and lymphadenectomy. Ninety five patients with bulky centro pelvic tumors received an external pelvic irradiation, a brachytherapy and surgery. The mean dose to whole pelvis was 40 Gy (18–50). Result Uncorrected five-year overall survival rate was 96% for stage Ib, 61% for stage IIA and 48% for stage IIB. Sterilization rate after irradiation was 82% for stage Ib, and 61% for stage IIA or IIB. Probability of survival was significantly better in case of tumor sterilization with a 5-year survival rate of 78% versus 65% and 61% for patients with microscopic residual disease and macroscopic persistent tumors, respectively. In univariate analysis, stage and node status according to the lymphography were prognostic factors. A multivariate analysis should be presented. Conclusion Histological sterilization after irradiation appeared as a favorable prognostic factor. Radio-surgical combination is an effective treatment for centro pelvic cervix carcinoma. Using preoperative radiotherapy, 80% of the patients have no residual disease at the time of surgery. The purpose of this study was to determine the prognostic value of the cervix sterilization after initial irradiation. Between 1976 and 1993, 200 patients with histologically proven cervix carcinoma (91 patients with clinical stage Ib tumor, 91 with stage IIA, and 18 with stage IIB) have been treated by irradiation followed by radical hysterectomy 6 weeks later. The mean age was 48 years. Median follow up was 86 months. One hundred and five patients underwent an utero-vaginal application of caesium 137. A dose of 60 Gy was delivered in the reference volume followed by radical hysterectomy and lymphadenectomy. Ninety five patients with bulky centro pelvic tumors received an external pelvic irradiation, a brachytherapy and surgery. The mean dose to whole pelvis was 40 Gy (18–50). Uncorrected five-year overall survival rate was 96% for stage Ib, 61% for stage IIA and 48% for stage IIB. Sterilization rate after irradiation was 82% for stage Ib, and 61% for stage IIA or IIB. Probability of survival was significantly better in case of tumor sterilization with a 5-year survival rate of 78% versus 65% and 61% for patients with microscopic residual disease and macroscopic persistent tumors, respectively. In univariate analysis, stage and node status according to the lymphography were prognostic factors. A multivariate analysis should be presented. Histological sterilization after irradiation appeared as a favorable prognostic factor.