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首页> 外文期刊>Annals of surgical oncology >Para-aortic involvement and interest of para-aortic lymphadenectomy after chemoradiation therapy in patients with stage IB2 and II cervical carcinoma radiologically confined to the pelvic cavity.
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Para-aortic involvement and interest of para-aortic lymphadenectomy after chemoradiation therapy in patients with stage IB2 and II cervical carcinoma radiologically confined to the pelvic cavity.

机译：在放射学上局限于骨盆腔的IB2和II期宫颈癌患者，放化疗后主动脉旁受累和对主动脉旁淋巴结清扫术的兴趣。

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BACKGROUND: Pelvic radiation therapy with concomitant chemotherapy (PCRT) is the standard treatment of stage IB2/II cervical carcinoma. The impact of concomitant chemotherapy on positive para-aortic nodes (PA+), however, remains unknown. The aim of this study was twofold: to evaluate the rate of histological PA+ after PCRT and to determine the survival of patients with PA+. METHODS: Patients fulfilling the following inclusion criteria were studied: (1) stage IB2/II cervical carcinoma, (2) histological subtype: squamous cell, adenocarcinoma or an adenosquamous tumor, (3) exclusion of patients with radiological PA+ (CT scan/MRI), (4) pelvic external radiation therapy of 45 Gy with concomitant chemotherapy (cisplatin 40 mg/m2/week) + utero-vaginal brachytherapy, and (5) completion surgery after the end of PCRT including at least a para-aortic lymphadenectomy. RESULTS: Seventy-three patients (16 stage IB2, 57 stage II) treated between 1998 and 2004 fulfilled all the inclusion criteria. PA+ after PCRT were observed in 13 patients (18%) with a median of five (range, 2-22) positive nodes. Overall and disease-free survival at 24 months in patients with PA+ was 40% and 17%. Only two patients with PA+ are currently alive and in remission. CONCLUSIONS: The rate of PA+ remains high after PCRT in patients treated for stage IB2/II cervical carcinoma. Furthermore, the survival rate of patients with PA+ is very low. These important results suggest that detection of PA + at the time of completion surgery (after PCRT) is not beneficial for improving survival.
机译：背景：盆腔放疗联合化疗（PCRT）是IB2 / II期宫颈癌的标准治疗方法。然而，伴随化疗对主动脉副旁淋巴结阳性（PA +）的影响仍然未知。这项研究的目的是双重的：评估PCRT后组织学PA +的发生率，并确定PA +患者的生存率。方法：对符合以下纳入标准的患者进行了研究：（1）IB2 / II期宫颈癌;（2）组织学亚型：鳞状细胞，腺癌或腺鳞状肿瘤;（3）排除放射PA +（CT扫描/ MRI）患者），（4）45 Gy盆腔外放疗并伴有化疗（顺铂40 mg / m2 /周）+子宫阴道近距离放疗，以及（5）PCRT结束后完成手术，包括至少主动脉旁淋巴结清扫术。结果：1998年至2004年间接受治疗的73例患者（16例IB2期，57例II期）符合所有纳入标准。 PCRT后的PA +在13例（18％）患者中观察到，中位值为五个（范围为2-22）阳性节点。 PA +患者24个月的总体生存率和无病生存率分别为40％和17％。目前只有两名PA +患者还活着并且正在缓解。结论：在接受PCRT治疗的IB2 / II期宫颈癌患者中，PA +的发生率仍然很高。此外，PA +患者的存活率非常低。这些重要结果表明，在完成手术时（PCRT之后）检测PA +不利于提高生存率。

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