Ginecologia y obstetricia de Mexico · 2010
[Pelvic exenterations for cervical cancer (prognosis factors)].
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Torres-Lobatón Alfonso, Lara-Gutiérrez Carlos, Torres-Rojo Alfonso, Román-Bassaure Edgar, Posada Juan Carlos Oliva, Morales-Palomares Miguel Angel, Hernández-Aten Dimas, Morgan-Ortiz Fred
Аннотация
BACKGROUND: Pelvic exenteration offers the last chance of cure for some patients with cervical cancer recurrent after radiation therapy.
OBJECTIVE: To analyze factors associated with recurrence and survival after pelvic exenterations, based on a 40 years institutional experience.
MATERIAL AND METHOD: Retrospective, longitudinal and closed study from files of patients who survived to exenterative procedures at Oncology Department at the Hospital General de México, from January 1966 to December 2006, were screened in order to know risk factors predicting recurrence and survival in a follow up for at least three years.
RESULTS: Prognostic factors in 161 patients eligible for this analysis were: diagnosis of recurrence prior 1 year 44/96 (45.8%) vs. 27/41 (65.8%) diagnosis after this time (p = 0.03), central recurrences 32/38 (84.2%) vs. 14/49 (28.5%) infiltration of lateral wall of the pelvis (0.0001), patients with 35 years old or less had a better prognosis when compared with the others: 23/33 (69%) vs. 60/128 (46%), (0.01); Infiltration of urinary bladder and or rectal wall 30/75 (40%) vs. 53/86 (61%) absence of these (0.006), tumor involving myometrium with or without adnexal metastases 6/25 (24%) vs. 77/136 (56%) absence of these reports (0.002), presence of three or more positive lymph nodes 5/16 (31%) vs. 56/90 (62%) absence of lymph nodes metastasis (0.02) and findings of hydronephrosis 2/15 (13.3%) vs. 13/19 (68.4%) of normal reports (0.01).
CONCLUSIONS: Better evolution in this series was for patients who had central recurrences.
OBJECTIVE: To analyze factors associated with recurrence and survival after pelvic exenterations, based on a 40 years institutional experience.
MATERIAL AND METHOD: Retrospective, longitudinal and closed study from files of patients who survived to exenterative procedures at Oncology Department at the Hospital General de México, from January 1966 to December 2006, were screened in order to know risk factors predicting recurrence and survival in a follow up for at least three years.
RESULTS: Prognostic factors in 161 patients eligible for this analysis were: diagnosis of recurrence prior 1 year 44/96 (45.8%) vs. 27/41 (65.8%) diagnosis after this time (p = 0.03), central recurrences 32/38 (84.2%) vs. 14/49 (28.5%) infiltration of lateral wall of the pelvis (0.0001), patients with 35 years old or less had a better prognosis when compared with the others: 23/33 (69%) vs. 60/128 (46%), (0.01); Infiltration of urinary bladder and or rectal wall 30/75 (40%) vs. 53/86 (61%) absence of these (0.006), tumor involving myometrium with or without adnexal metastases 6/25 (24%) vs. 77/136 (56%) absence of these reports (0.002), presence of three or more positive lymph nodes 5/16 (31%) vs. 56/90 (62%) absence of lymph nodes metastasis (0.02) and findings of hydronephrosis 2/15 (13.3%) vs. 13/19 (68.4%) of normal reports (0.01).
CONCLUSIONS: Better evolution in this series was for patients who had central recurrences.