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Retrospective Analysis of Surgery Following Radical Irradiation for 82 Cases with Gynecologic Cancer

BAI Ping, LI Xiao-jiang, YU Gao-zhi, et al. (Cancer Hospitol, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100021, China)  
[Purpose] To investigate the clinical outcome of the cervical and endometrial carcinomas treated with surgery following whole dose irradiation therapy. [Methods] Seventy-one cases with cervical carcinoma and 11 cases with endometrial carcinoma were managed initially by radical radiotherapy. Surgery was performed for recurrent or persistent disease, including extrafascial hysterectomy in 57 cases, salpingo-oophrectomy in 9 cases and radical hysterectomy or modified radical hysterectomy in 10 cases. [Results] The mean operation time was 2.7 hours in extrafascial hysterectomy group, 3.8 hours in radical or modified group, and 1.8 hours in salpingo-oophrectomy group. Surgical blood loss was 200ml in 39 cases, ≥200ml in 30 cases with mean 462ml. The overall surgical complications was 14.7%, including wound dehiscence in 3 cases, wound infect in 3 cases, urinary complications in 4 case, bowel fistula in 1 case, and bowel injury in 1 case. Surgical specimens in 39 cases pathologically revealed cervical residual cancer or recurrences. The 5-year survival of these 39 cases was 44.3%. The 5-year survival was 64.5% in 16 cases with persistent disease or new diagnosed endometrial carcinoma. [Conclusion] Surgical complications relatively increase after whole dose radiotherapy, however the extrafascial hysterectomy is still the treatment modality with effect and safety.
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