Treatment for locally resectable stage IIIC1r cervical cancer: surgery or chemoradiotherapy?

OBJECTIVE: The aim of this study was to compare the therapeutic value and treatment-related complications of radical hysterectomy with those of concurrent chemoradiotherapy (CCRT) for locally resectable (T1a2-T2a1) stage IIIC1r cervical cancer. METHODS: A total of 213 patients with locally resectable stage IIIC1r cervical cancer who had been treated at Jiangxi Maternal and Child Health Care Hospital between January 2013 and December 2021 were included in the study and classified into two groups: surgery (148 patients) and CCRT (65 patients). The disease-free survival (DFS) rate, overall survival (OS) rate, side effects, and economic costs associated with the two groups were compared. RESULTS: 43.9% (65/148) patients in the surgical group had no pelvic lymph node metastasis, and 21of them did not require supplementary treatment after surgery due to a low risk of postoperative pathology. The median follow-up time was 46 months (range: 7-108 months). The five-year DFS and OS rates of the surgery group were slightly higher than those of the CCRT group (80.7% vs. 75.1% and 81.6% vs. 80.6%, respectively; p > 0.05). The incidences of grade III-IV gastrointestinal reactions in the surgery and CCRT groups were 5.5% and 9.2%, respectively (p = 0.332). Grade III-IV myelosuppression was identified in 27.6% of the surgery group and 26.2% of the CCRT group (p = 0.836). The per capita treatment cost was higher for the surgery group than for the CCRT group (RMB 123, 918.6 0 vs. RMB 101, 880.90, p = 0.001). CONCLUSION: The therapeutic effects and treatment-related complications of hysterectomy and CCRT are equivalent in patients with locally resectable stage IIIC1r cervical cancer, but surgery can provide accurate lymph node information and benefit patients with unnecessary radiation.

[Study of the risk factors for ovarian metastasis in patients with endometrial carcinoma].

UNLABELLED: OBJECTIVE To investigate the risk factors for ovarian metastasis and the possibility of ovarian preservation in patients with endometrial carcinoma. METHODS: The clinicopathological features of endometrial carcinoma patients who were diagnosed and treated initially with a surgical staging procedure from Jan 1997 to Dec 2006 in our hospital were retrospectively reviewed. RESULTS: Of the 638 cases reviewed, 36 (5.6%, 36/638) had ovarian metastasis. Univariate analysis revealed that histological type and grade, myometrial invasion, positive peritoneal fluid cytology, pelvic lymph node metastasis, invasion of parauterine, para-aortic node metastasis and invasion of uterine serosa were significantly associated with ovarian metastasis (P < 0.05); while age, lymph-vascular invasion and cervical invasion were not significantly associated with ovarian metastasis (P > 0.05). Factors predictive of ovarian metastasis by multivariate analysis were ranked as follows according to risk intensity: pelvic lymph node metastasis, positive peritoneal cytology, and histological grade. CONCLUSION: In young patients with grade 1 endometrioid carcinoma, with no pelvic lymph node metastasis, no para-aortic lymph node metastasis, no myometrial invasion and with negative peritoneal fluid cytology, ovarian preservation could be considered.