Long-standing complications after treatment for cancer of the uterine cervix-clinical significance of medical examination at 5 years after treatment

Abstract

The purpose of this study is to investigate the side effect in patients who survived for more than 5 years after initial treatment for invasive cervical cancer. Between January 1984 and December 1997, 341 patients underwent primary treatment for invasive cervical cancer. One hundred nine patients who underwent medical examinations at 5 years after primary treatment were reviewed. The patients were divided into three groups: radical surgery alone (group A), radiotherapy alone (group B), and radical surgery with postoperative radiotherapy (group C). Dysuria was seen in 8%, and positive catheterized urine culture was noted in about 20% of groups A and C. Hydronephrosis was seen in 2% and 9% of groups A and B, respectively. Colitis or ulcer detected by proctosigmoidoscopy was noted in 15%, 50%, and 43% of groups A, B, and C, respectively, frequently observed in radiotherapy group (P= 0.0029). Lymphocyst was still present in 6% of group A, and leg edema was noted in 14%, 6%, and 15% of groups A, B, and C, respectively. Long-standing abnormal findings including urinary and bowel complications were presented in this study. Periodic physical examination after treatment should be performed because complications existed over a long time.

Approaches to surgical staging of cancer of the uterine cervix

“…Безусловно, в этом вопросе важен фактор поражения лимфатических узлов, так как при анализе рецидивов заболевания около 17 % наблюдений связаны с метастазами в лимфатических узлах [13]. Из этого можно сделать вывод, что на момент выбора первичного метода лечения эти метастазы уже суще-ствовали, но не были диагностированы.…”

Radiation and Other Physicochemical Injury

“…The incidence of chronic radiation colitis (RC) in long-term follow-up after pelvic radiotherapy can be up to 50% [6]. The relatively high incidence of rectosigmoid involvement is due to the fact that pelvic malignancies are both common and commonly treated with radiotherapy.…”

Beyond sentinel node algorithm. Toward a more tailored surgery for cervical cancer patients

“…However, pelvic/aortic lymphadenectomy (LND) is associated with short‐ and long‐term morbidities, such as prolonged duration of surgery, increased blood loss, infection, nerve and vascular injury, venous thromboembolism, lymphocyst formation, and lower extremity lymphedema 6, 7, 8, 9. In an effort to decrease complications associated with “unnecessary” LND and, at the same time, to assess LN status, sentinel lymph node (SLN) biopsy technique has been developed and investigated by multiple groups with encouraging data in terms of sensitivity and negative predictive value (NPV) 10, 11, 12.…”