Completion surgery after concomitant chemoradiation in locally advanced cervical cancer: A comprehensive analysis of pattern of postoperative complications

Gabriella Ferrandina, Alfredo Ercoli, Anna Fagotti, Francesco Fanfani, Valerio Gallotta, Alessandro P. Margariti, Maria Giovanna Salerno, Vito Chiantera, Francesco Legge, Gabriella Macchia, Alessio G. Morganti, Vincenzo Valentini, Giovanni Scambia

Research output: Contribution to journalArticle

Abstract

Background: We provided a comprehensive analysis of rate, pattern, and severity of early and late postoperative complications in a very large, single-institution series of locally advanced cervical cancer (LACC) patients administered CT/RT plus radical surgery (RS). Methods: A total of 362 consecutive LACC (FIGO stage IB2-IVA) patients were submitted to RS after CT/RT at the Gynecologic Oncology Unit of the Catholic University (Rome/Campobasso). At 4 weeks after CT/RT, patients were evaluated for objective response and triaged to radical hysterectomy and pelvic ± aortic lymphadenectomy. Surgical morbidity was classified according to the Chassagne's grading system. Results: Most cases underwent type III-IV radical hysterectomy (N = 313, 86.5 %); pelvic lymphadenectomy was performed in all patients, while 116 patients (32.1 %) were also submitted to aortic lymphadenectomy. A total of 93 patients (25.7 %) experienced any grade postoperative complications, and 60 (16.6 %) had ≥grade 2 complications; grade 3-4 complications occurred in 21 patients (5.8 %). Of all early postoperative complications (N = 100), 31 (31.0 %) were urinary, 9 (9.0 %) were gastrointestinal, and 45 (45.0 %) were vascular. Of all late complications (N = 31), 20 (64.5 %) were urinary, 7 (22.6 %) gastrointestinal, and 2 (6.4 %) were vascular. Multivariate analysis showed that not complete clinical response to treatment retained an independent, unfavorable association with risk of development of postoperative morbidity, while advanced stage, and aortic lymphadenectomy showed only a borderline value. Conclusions: Failure to achieve clinical complete response to treatment and, to a lesser extent, more advanced stage, and aortic lymphadenectomy, were associated with a higher risk of developing any grade as well as ≥grade 2 complications.

Original languageEnglish
Pages (from-to)1692-1699
Number of pages8
JournalAnnals of Surgical Oncology
Volume21
Issue number5
DOIs
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Surgery
  • Oncology
  • Medicine(all)

Fingerprint Dive into the research topics of 'Completion surgery after concomitant chemoradiation in locally advanced cervical cancer: A comprehensive analysis of pattern of postoperative complications'. Together they form a unique fingerprint.

  • Cite this

    Ferrandina, G., Ercoli, A., Fagotti, A., Fanfani, F., Gallotta, V., Margariti, A. P., Salerno, M. G., Chiantera, V., Legge, F., Macchia, G., Morganti, A. G., Valentini, V., & Scambia, G. (2014). Completion surgery after concomitant chemoradiation in locally advanced cervical cancer: A comprehensive analysis of pattern of postoperative complications. Annals of Surgical Oncology, 21(5), 1692-1699. https://doi.org/10.1245/s10434-013-3471-y