Radiotherapy outcomes in patients with locally advanced cervical carcinoma and previous hysterectomy: a retrospective analysis
DOI:
https://doi.org/10.35509/01239015.978Palabras clave:
Uterine cervical neoplasms, hysterectomy, radiotherapyResumen
Objective: This study aims to assess the proportion of inappropriate hysterectomies and their subsequent impact on patients with cervical cancer admitted to our Radiotherapy Unit.
Methods: A retrospective cohort study was conducted using data extracted from medical records at the Hospital Oncológico Solón Espinosa Ayala (SOLCA) (Quito, Ecuador) between 2012 and 2015. A systematic review of hospital records identified instances of inadequate surgery, encompassing both simple hysterectomies for stages IB2 to IIA and any hysterectomy type for stages IIB or higher. Comprehensive data were accurately collected, including demographic information, histology, postoperative diagnostic investigations, and postoperative management. Patient follow-up was meticulously recorded to track occurrences of recurrence, progression, or death up to five years after treatment conclusion.
Results: A total of 641 patients diagnosed with cervical carcinoma and referred for chemoradiotherapy were identified; 81 patients (12.8%) referred in stages IB2 to IVA met the criteria for inadequate hysterectomy, with 11 patients (13.6%) showing residual lesions and 12 patients (14.8%) having positive margins. The mean overall survival (OS) of patients with inadequate hysterectomy was 77.5 months (CI95%=69.3-85.7), with a median disease-free survival (DFS) of 92 months (CI95%=65.5-118.4 months); 19 patients (23.4%) succumbed to the disease. Notably, patients with residual disease exhibited the worst OS and DFS outcomes.
Conclusions: A representative group of cervical cancer patients referred to the Radiotherapy Unit underwent inadequate hysterectomy. Within this group, patients with residual disease had worse oncological outcomes.
Biografía del autor/a
Raúl Andrés Puente-Vallejo, Departamento de Radioterapia, Hospital Oncológico Solón Espinosa Ayala (SOLCA), Núcleo de Quito, Quito D. M., Ecuador.
1. Departamento de Radioterapia, Hospital Oncológico Solón Espinosa Ayala (SOLCA), Núcleo de Quito, Quito D. M., Ecuador.
2. Facultad de Medicina, Universidad de las Américas, Quito D. M., Ecuador.
Nadia Gabriela Montero-Oleas, Departamento de Radioterapia, Hospital Oncológico Solón Espinosa Ayala (SOLCA), Núcleo de Quito, Quito D. M., Ecuador.
1. Departamento de Radioterapia, Hospital Oncológico Solón Espinosa Ayala (SOLCA), Núcleo de Quito, Quito D. M., Ecuador.
3. Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito D. M., Ecuador.
Cecilia Carolina Jaramillo-Gómez, Departamento de Radioterapia, Hospital Oncológico Solón Espinosa Ayala (SOLCA), Núcleo de Quito, Quito D. M., Ecuador.
1. Departamento de Radioterapia, Hospital Oncológico Solón Espinosa Ayala (SOLCA), Núcleo de Quito, Quito D. M., Ecuador.
María José Muñoz-Viteri, Departamento de Oncología Clínica, Hospital Oncológico Solón Espinosa Ayala (SOLCA), Núcleo de Quito, Quito D. M., Ecuador.
4. Departamento de Oncología Clínica, Hospital Oncológico Solón Espinosa Ayala (SOLCA), Núcleo de Quito, Quito D. M., Ecuador.
Mayra Pamela Ochoa-Lantigua, Estudiante universitario, Escuela de Medicina, Facultad de Ciencias de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito D. M., Ecuador.
5. Estudiante universitario, Escuela de Medicina, Facultad de Ciencias de la Salud y de la Vida, Universidad Internacional del Ecuador, Quito D. M., Ecuador.
Diego Fernando Paredes-Vinueza, Posgrado de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito D. M., Ecuador.
6. Posgrado de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito D. M., Ecuador.
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