Completion surgery after concomitant chemoradiation in locally advanced cervical cancer: A comprehensive analysis of pattern of postoperative complications

Vito Chiantera, Maria Giovanna Salerno, Giovanni Scambia, Francesco Legge, Alessandro P. Margariti, Vito Chiantera, Alfredo Ercoli, Francesco Fanfani, Anna Fagotti, Gabriella Ferrandina, Gabriella Macchia, Vincenzo Valentini, Alessio G. Morganti, Giovanni Scambia, Valerio Gallotta

Risultato della ricerca: Articlepeer review

47 Citazioni (Scopus)

Abstract

Background: We provided a comprehensive analysis of rate, pattern, and severity of early and late postoperative complications in a very large, single-institution series of locally advanced cervical cancer (LACC) patients administered CT/RT plus radical surgery (RS). Methods: A total of 362 consecutive LACC (FIGO stage IB2-IVA) patients were submitted to RS after CT/RT at the Gynecologic Oncology Unit of the Catholic University (Rome/Campobasso). At 4 weeks after CT/RT, patients were evaluated for objective response and triaged to radical hysterectomy and pelvic ± aortic lymphadenectomy. Surgical morbidity was classified according to the Chassagne's grading system. Results: Most cases underwent type III-IV radical hysterectomy (N = 313, 86.5 %); pelvic lymphadenectomy was performed in all patients, while 116 patients (32.1 %) were also submitted to aortic lymphadenectomy. A total of 93 patients (25.7 %) experienced any grade postoperative complications, and 60 (16.6 %) had ≥grade 2 complications; grade 3-4 complications occurred in 21 patients (5.8 %). Of all early postoperative complications (N = 100), 31 (31.0 %) were urinary, 9 (9.0 %) were gastrointestinal, and 45 (45.0 %) were vascular. Of all late complications (N = 31), 20 (64.5 %) were urinary, 7 (22.6 %) gastrointestinal, and 2 (6.4 %) were vascular. Multivariate analysis showed that not complete clinical response to treatment retained an independent, unfavorable association with risk of development of postoperative morbidity, while advanced stage, and aortic lymphadenectomy showed only a borderline value. Conclusions: Failure to achieve clinical complete response to treatment and, to a lesser extent, more advanced stage, and aortic lymphadenectomy, were associated with a higher risk of developing any grade as well as ≥grade 2 complications. © 2014 Society of Surgical Oncology.
Lingua originaleEnglish
pagine (da-a)1692-1699
Numero di pagine8
RivistaAnnals of Surgical Oncology
Volume21
Stato di pubblicazionePublished - 2014

All Science Journal Classification (ASJC) codes

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