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J Surg Oncol ; 100(6): 505-10, 2009 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-19653248

RESUMO

BACKGROUND: Surgical staging (SS) is the gold standard for determination of the true extent of a patient's disease and is an important prognostic factor in cervical cancer. We investigated whether lymph node dissection (LND) prior to chemotherapy (CT) followed by radical surgery (RS) could modified overall (OS) and disease-free survival (DFS). METHODS: We performed a cohort analysis of 98 patients with cervical carcinoma. The experimental group consisted of 36 patients who underwent SS followed by neoadjuvant chemotherapy, and then by RS (objective response) or chemo-radiation therapy (with or without subsequent surgery when not possible). The control group consisted of 62 similarly treated patients without pretreatment SS. The value of this procedure as a diagnostic tool in defining the extent of disease was evaluated. Furthermore, LND/CT-associated treatment complications and the impacts on OS and DFS were also evaluated. RESULTS: Fourteen (38.9%) patients had pelvic LN metastases and three (8.3%) patients had pelvic and para-aortic LN metastases. The 39-month OS and DFS rates for the current study were 80.6% for the staged group and 52% for non-staged treatment (P < 0.001). CONCLUSION: SS in cervical cancer is a feasible and safe pretreatment procedure, and when associated with CT, it improves OS and DFS.


Assuntos
Carcinoma/mortalidade , Carcinoma/patologia , Estadiamento de Neoplasias/métodos , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/patologia , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/terapia , Estudos de Casos e Controles , Cisplatino/administração & dosagem , Estudos de Coortes , Terapia Combinada , Intervalo Livre de Doença , Feminino , Fluoruracila/administração & dosagem , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Metástase Linfática , Pessoa de Meia-Idade , Neoplasias do Colo do Útero/terapia
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