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001-es BibID:BIBFORM069986
035-os BibID:(WoS)000408892500019
Első szerző:Póka Róbert (szülész-nőgyógyász, klinikai onkológus)
Cím:Intention-to-Treat Analysis of Radical Trachelectomy for Early-Stage Cervical Cancer With Special Reference to Oncologic Failures / Póka Robert, Molnár Szabolcs, Daragó Péter, Lukács János, Lampé Rudolf, Krasznai Zoárd, Hernádi Zoltán
Megjegyzések:Objective: Theaimofourstudywastoevaluateclinicalandpathologicaldatainorderto draw eligibility criteria for oncologically sufficient radical trachelectomy (RT) in early-stage cervical cancer. Reviewing all cases of attempted RT performed at our unit, we focused attention on prognostic indicators of the need for additional oncologic treatment following RT. The analysis was extended by extensive literature review to include previously published cases of oncologic failures.Methods: The authors retrospectively analyzed data of patients who underwent RT at the Department of Obstetrics and Gynecology, University of Debrecen. Electronic records and case notes of RT cases were reviewed to determine the incidence of abdominal and vaginal route, distribution of clinicopathologic data, and follow-up results of individual cases. Individual procedures were categorized as oncologically insufficient if additional oncologic treatment was necessary following RT. Theoretical eligibility criteria for RT in early-stage cervical cancer were determined retrospectively by selecting prognostic features that were associated with oncologic insufficiency from clinicopathologic indicators of the complete series.Results: Twenty-four cases of RT were performed by the authors, 15 vaginal RTs with laparoscopic pelvic lymphadenectomy and 9 abdominal RTs with open pelvic lymphade- nectomy. Fifteen of 24 cases proved oncologically sufficient. Three cases required imme- diate conversion to radical hysterectomy because of positive sentinel nodes and/or positive isthmic disc on frozen section. In further 5 cases, final pathology results indicated additional oncologic treatment, that is, radical hysterectomy (n = 2), chemoradiotherapy (n = 2), or chemotherapy (n = 1). One patient among immediately converted cases and another 3 among those who required additional oncologic treatment died of their disease later. There were no other cases of recurrences over a median follow-up of 34 months (range, 12Y188 months). Factors that may predict oncologic insufficiency of RTwere stage IB1 or greater, tumor size of greater than 2 cm in 1 dimension or greater than 15 mm in 3 dimensions, G3, nonsquamous/ adeno histological type, stromal invasion of greater than 9 mm, and lymphovascular space involvement in the primary tumor.Conclusions: Most cases of oncologically insufficient RTs have significant risk features that can be identified preoperatively. There is a need for more clinicopathologic data on oncologic failure of RT cases in order to improve patient selection.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Cervical cancer
Clinicopathologic predictors
Fertility-sparing surgery
Oncologic failure
Megjelenés:International Journal Of Gynecological Cancer. - 27 : 7 (2017), p. 1438-1445. -
További szerzők:Molnár Szabolcs (1987-) (szülész-nőgyógyász szakorvos) Daragó Péter Lukács János (1975-) (szülész-nőgyógyász, genetikus) Lampé Rudolf (1983-) (szülész-nőgyógyász) Krasznai Zoárd Tibor (1973-) (szülész-nőgyógyász, gyermeknőgyógyász) Hernádi Zoltán (1948-) (szülész-nőgyógyász, klinikai onkológus)
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