| Author/Editor | Rakar, Stelio | |
| Title | Optimal surgical treatment of cervical cancer | |
| Type | članek | |
| Source | In: Šamija M, Juretić A, editors. Zbornik radova 1. kongres Hrvatskog onkološkog društva; 2001 stu 28-30; Zagreb. Zagreb: Medicinska naklada, | |
| Publication year | 2001 | |
| Volume | str. 101-2 | |
| Language | slo | |
| Abstract | Our analysis of 237 cases treated in the period 1981-1997 has shown that patients with microinvasive cervical cancer stage IA have a minimal risk of extracervical metastatic spread and recurrence, therefore they can be treated with less radical surgery. According to our scoring system, based on the evaluation of morphological criteria (cellular type, mitotic activity, depth of invasion, type of invasion -solitary buds, drops, confluent type, degree of lymphocyte infiltration and presence of lympho-vascular space invasion) there are no more indications for radical hysterectomy. More than 65% of stage IA cases can be safely treated by conization alone. Wertheim procedure with pelvic lymphadenectomy is the treatment of choice in patients with localized disease: the surgery is performed in patients in good general condition, aged less than 65-70 years who have stage IB or IIA (early stage IIB only exceptionally). Our latest survival analysis of patients with stage IB and IIA cervical cancer, operated at our Department in the period 1988-95 showed the 3-year survival rate to be 92.8% (269/290 patients) and the 5-year survival rate to be 90.0% (181/201 patients) The recurrences occur mainly within the first 3 years after operation. Our data show that there is no significant difference in survival of squamous cell carcinoma (91 %) and adenocarcinoma (83%) cases and that the worst prognostic factor (which correlates with the tumour volume) is lymph node involvement:14% of patients had positive nodes and only a 75% survival rate compared with a 92.4% survival rate in patients with negative nodes. Postoperative irradiation (rarely in combination with chemotherapy) was used in node positive or cases with deep cervical invasion. Of the 544 patients operated in the period 1988-98 major complications were rare: no case of primary mortality, 2% of pelvic infection and 1 % of ureterovaginal fistulas. (Abstract truncated at 2000 characters) | |
| Descriptors | CERVIX NEOPLASMS NEOPLASM STAGING HYSTERECTOMY CONIZATION SURVIVAL ANALYSIS RECURRENCE CARCINOMA, SQUAMOUS CELL ADENOCARCINOMA |