Prognostic factors associated with radical hysterectomy failure

Thomas W. Burke, William J. Hoskins, Paul Heller, Mary C. Bibro, Edward B. Weiser, Robert C. Park

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Two hundred seventy-five patients who underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB carcinoma of the cervix between 1961 and 1982 were retrospectively analyzed to identify specific risk factors associated with treatment failure. Patients were classified as high or low risk on the basis of tumor spread to pelvic lymph nodes or surgical margins. Thirty-eight patients had tumor involvement of pelvic nodes or surgical margins. Despite postoperative whole pelvis radiation therapy in 88% of patients, 13 (34.2%) developed recurrence. All patients with involved nodes or margins who recurred died of disease. Patients with pelvic lymph node or surgical margin involvement clearly constitute a high risk group and should be considered candidates for some form of adjuvant therapy. Two hundred thirty-seven patients had negative nodes and clear surgical margins. There were 18 recurrences (7.6%) in this group. Pathologic specimens were reviewed to evaluate additional histologic criteria which might identify those patients at greatest risk for tumor recurrence in this low risk group. Patients whose tumors contained vascular-lymphatic space invasion or adenomatous histologic components recurred more frequently than patients whose tumors did not (P < 0.05). Eighty-three percent of low risk patients who recurred had tumors with at least one of these features. Degree of differentiation and depth of invasion did not correlate with risk of recurrence. Prospective randomized trials are needed to determine the effectiveness of postoperative adjuvant therapy for patients at risk for recurrent disease.

Original languageEnglish (US)
Pages (from-to)153-159
Number of pages7
JournalGynecologic Oncology
Volume26
Issue number2
DOIs
StatePublished - Jan 1 1987
Externally publishedYes

Fingerprint

Hysterectomy
Recurrence
Neoplasms
Lymph Nodes
Lymph Node Excision
Treatment Failure
Pelvis
Cervix Uteri
Blood Vessels
Radiotherapy
Carcinoma

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynecology

Cite this

Burke, T. W., Hoskins, W. J., Heller, P., Bibro, M. C., Weiser, E. B., & Park, R. C. (1987). Prognostic factors associated with radical hysterectomy failure. Gynecologic Oncology, 26(2), 153-159. https://doi.org/10.1016/0090-8258(87)90268-X
Burke, Thomas W. ; Hoskins, William J. ; Heller, Paul ; Bibro, Mary C. ; Weiser, Edward B. ; Park, Robert C. / Prognostic factors associated with radical hysterectomy failure. In: Gynecologic Oncology. 1987 ; Vol. 26, No. 2. pp. 153-159.
@article{af559ab399c2456c821baf026197bf8b,
title = "Prognostic factors associated with radical hysterectomy failure",
abstract = "Two hundred seventy-five patients who underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB carcinoma of the cervix between 1961 and 1982 were retrospectively analyzed to identify specific risk factors associated with treatment failure. Patients were classified as high or low risk on the basis of tumor spread to pelvic lymph nodes or surgical margins. Thirty-eight patients had tumor involvement of pelvic nodes or surgical margins. Despite postoperative whole pelvis radiation therapy in 88{\%} of patients, 13 (34.2{\%}) developed recurrence. All patients with involved nodes or margins who recurred died of disease. Patients with pelvic lymph node or surgical margin involvement clearly constitute a high risk group and should be considered candidates for some form of adjuvant therapy. Two hundred thirty-seven patients had negative nodes and clear surgical margins. There were 18 recurrences (7.6{\%}) in this group. Pathologic specimens were reviewed to evaluate additional histologic criteria which might identify those patients at greatest risk for tumor recurrence in this low risk group. Patients whose tumors contained vascular-lymphatic space invasion or adenomatous histologic components recurred more frequently than patients whose tumors did not (P < 0.05). Eighty-three percent of low risk patients who recurred had tumors with at least one of these features. Degree of differentiation and depth of invasion did not correlate with risk of recurrence. Prospective randomized trials are needed to determine the effectiveness of postoperative adjuvant therapy for patients at risk for recurrent disease.",
author = "Burke, {Thomas W.} and Hoskins, {William J.} and Paul Heller and Bibro, {Mary C.} and Weiser, {Edward B.} and Park, {Robert C.}",
year = "1987",
month = "1",
day = "1",
doi = "10.1016/0090-8258(87)90268-X",
language = "English (US)",
volume = "26",
pages = "153--159",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "2",

}

Burke, TW, Hoskins, WJ, Heller, P, Bibro, MC, Weiser, EB & Park, RC 1987, 'Prognostic factors associated with radical hysterectomy failure', Gynecologic Oncology, vol. 26, no. 2, pp. 153-159. https://doi.org/10.1016/0090-8258(87)90268-X

Prognostic factors associated with radical hysterectomy failure. / Burke, Thomas W.; Hoskins, William J.; Heller, Paul; Bibro, Mary C.; Weiser, Edward B.; Park, Robert C.

In: Gynecologic Oncology, Vol. 26, No. 2, 01.01.1987, p. 153-159.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic factors associated with radical hysterectomy failure

AU - Burke, Thomas W.

AU - Hoskins, William J.

AU - Heller, Paul

AU - Bibro, Mary C.

AU - Weiser, Edward B.

AU - Park, Robert C.

PY - 1987/1/1

Y1 - 1987/1/1

N2 - Two hundred seventy-five patients who underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB carcinoma of the cervix between 1961 and 1982 were retrospectively analyzed to identify specific risk factors associated with treatment failure. Patients were classified as high or low risk on the basis of tumor spread to pelvic lymph nodes or surgical margins. Thirty-eight patients had tumor involvement of pelvic nodes or surgical margins. Despite postoperative whole pelvis radiation therapy in 88% of patients, 13 (34.2%) developed recurrence. All patients with involved nodes or margins who recurred died of disease. Patients with pelvic lymph node or surgical margin involvement clearly constitute a high risk group and should be considered candidates for some form of adjuvant therapy. Two hundred thirty-seven patients had negative nodes and clear surgical margins. There were 18 recurrences (7.6%) in this group. Pathologic specimens were reviewed to evaluate additional histologic criteria which might identify those patients at greatest risk for tumor recurrence in this low risk group. Patients whose tumors contained vascular-lymphatic space invasion or adenomatous histologic components recurred more frequently than patients whose tumors did not (P < 0.05). Eighty-three percent of low risk patients who recurred had tumors with at least one of these features. Degree of differentiation and depth of invasion did not correlate with risk of recurrence. Prospective randomized trials are needed to determine the effectiveness of postoperative adjuvant therapy for patients at risk for recurrent disease.

AB - Two hundred seventy-five patients who underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB carcinoma of the cervix between 1961 and 1982 were retrospectively analyzed to identify specific risk factors associated with treatment failure. Patients were classified as high or low risk on the basis of tumor spread to pelvic lymph nodes or surgical margins. Thirty-eight patients had tumor involvement of pelvic nodes or surgical margins. Despite postoperative whole pelvis radiation therapy in 88% of patients, 13 (34.2%) developed recurrence. All patients with involved nodes or margins who recurred died of disease. Patients with pelvic lymph node or surgical margin involvement clearly constitute a high risk group and should be considered candidates for some form of adjuvant therapy. Two hundred thirty-seven patients had negative nodes and clear surgical margins. There were 18 recurrences (7.6%) in this group. Pathologic specimens were reviewed to evaluate additional histologic criteria which might identify those patients at greatest risk for tumor recurrence in this low risk group. Patients whose tumors contained vascular-lymphatic space invasion or adenomatous histologic components recurred more frequently than patients whose tumors did not (P < 0.05). Eighty-three percent of low risk patients who recurred had tumors with at least one of these features. Degree of differentiation and depth of invasion did not correlate with risk of recurrence. Prospective randomized trials are needed to determine the effectiveness of postoperative adjuvant therapy for patients at risk for recurrent disease.

UR - http://www.scopus.com/inward/record.url?scp=0023111010&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023111010&partnerID=8YFLogxK

U2 - 10.1016/0090-8258(87)90268-X

DO - 10.1016/0090-8258(87)90268-X

M3 - Article

VL - 26

SP - 153

EP - 159

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 2

ER -