Outcome of Patients with Cervical and Vaginal Stump Carcinomas Treated with More Conservative Surgical Approaches: a 9-Year Experience of a Tertiary Oncology Center

Springer Science and Business Media LLC - Tập 8 - Trang 267-273 - 2017
Mohamed Hegazy1, Ashraf Khater1, Mohamed Awad2, Sherif Kotb1, Waleed Elnahas1, Sameh Roshdy1, Osama Eldamshety1, Fayez Shahatto1, Omar Farouk1, Emadeldeen Hamed1, Refaat Hegazi3, Ola T. Abdel Dayem4, Anas M. Gamal5
1Department of Surgical Oncology, Oncology Center- Mansoura University, Egypt (OCMU), Mansoura, Egypt
2Department of Medical Oncology, Oncology Center- Mansoura University, Egypt (OCMU), Mansoura, Egypt
3Department of Preventive Medicine, Mansoura University, Mansoura, Egypt
4Departments of Anesthesia and Intensive Care, Mansoura University, Mansoura, Egypt
5Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt

Tóm tắt

The surgical management of stump carcinoma includes the gold standard pelvic exenteration and more conservative approaches. This study aimed to investigate the outcome among a cohort of vaginal and cervical stump carcinomas that were treated with an intent of organ preservation. This is a prospective study of 60 patients with a biopsy confirmed stump carcinomas at a tertiary care oncology center in Egypt. The demographic, surgical, and pathological data were collected and patients underwent radical surgery with an intent of organ preservation guided by margin negativity. The pathologic data were correlated with the postoperative mortality. Correlation coefficients were calculated for simple correlation and regression analysis was used to investigate the independent predictors of survival. Pelvic exenteration was conducted in 30/60 (50%), while wide local excision with safety margins was possible in 26/60 (43%) and in two cases, resection was precluded. Mean hospital stay in days was 19 ± 9 (range 4–61). Overall operative morbidity was 83.3% (50/60). Perioperative mortality was 6.7% (4/60). Five-year disease-free survival was 40% (24/60). Five-year overall survival was 50% (30/60). The resection margin status and the perioperative therapy were independent prognostic factors of DFS (p = 0.003 and 0.02, respectively. Only the resection margin status was significantly associated with overall survival (p = 0.009). There was no increased mortality with introduction of more conservative surgical approaches. The resection margin status is the most important determinant of recurrence free and overall survivals.

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