FIGO Stage IB2 cervix cancer and putting all your eggs in one basket
2004; Elsevier BV; Volume: 94; Issue: 2 Linguagem: Inglês
10.1016/j.ygyno.2004.06.019
ISSN1095-6859
Autores Tópico(s)Colorectal and Anal Carcinomas
ResumoThe controversy over the preferred treatment for early cervix cancer—primary radical surgery or primary radical radiation—has existed for many decades. There are a number of advantages to the primary surgical management of early cervix cancer, especially in the young woman if it is the only treatment required. Overall treatment time is shorter, ovarian function is preserved, accurate pathologic extent of disease is established, sexual function may be better (although this has never been clearly established), and late radiation sequelae are avoided. However, if adjuvant radiation and chemotherapy are indicated or necessary, then all these advantages are obviated. The sole randomized trial comparing primary surgery vs. primary radiotherapy reported by Landoni has demonstrated that these two modalities are equally effective in providing cure [ [1] Landoni F Maneo A Colombo A et al. Randomized study of radical surgery versus radiotherapy for stage IB-IIA cervical cancer. Lancet. 1997; 350: 535-540 Abstract Full Text Full Text PDF PubMed Scopus (1422) Google Scholar ]. However, of the 46 stage 1B2 patients who underwent combined modality therapy, 24% had grade 2/3 complications compared to 11% of 54 patients who were treated with primary radiation therapy alone. How do we then choose primary therapy? Furthermore, what is an acceptable or reasonable rate for the need of adjuvant treatment following surgery rendering the surgical treatment redundant? Many would consider a rate of 10 to 20% to be reasonable [ [2] Morris M Editorial: Early cervical carcinoma: Are two treatments better than one?. Gynecol. Oncol. 1994; 54: 1-3 Abstract Full Text PDF PubMed Scopus (14) Google Scholar ].
Referência(s)