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2002, Number 3

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Cir Cir 2002; 70 (3)

Cervical cancer. Some considerations about radical surgery

Torres-Lobatón A

Language: Spanish
References: 18
Page: 183-187
PDF size: 40.73 Kb.


ABSTRACT

Radical surgery is treatment of choice in young patients with stages Ibl and IIa cervical cancer and represents the salvage procedure for radiation therapy failures in this disease. At the Mexico City SSA General Hospital morbidity of radical hysterectomy in stages Ib and IIa is mainly related with urinary disorders: 18.1% of vesical dysfunction and 2% of urinary fistules. Postoperative mortality in this procedure is practically 0 and follow-up without cancer at 2 years at this Institution is 89.6% for stage Ib and 72.5% for IIa. Quality of life in these patients is good and adverse prognostic factors occurred in presence of lymph node metastases and diagnosis of adenocarcinoma. A total of 39.8% of laparotomized patients with localized cervical cancer recurrent after radiation therapy were subjected to exenterative procedures. There were 413 of these operations in 32 years at the previonsly mentioned Institution with actual morbidity of 44.7% and < 8% postoperative mortality. Forty nine percent of patients who survived to ultrarradical surgery had a follow-up from 3 to 10 years without evidence of disease. Adverse prognostic factors in this series were lateral parametrial involvement, myometrial invasion, hydronephrosis, and three or more positive lymph nodes. Surgical procedures considered for better quality of life in these cases, such as ileocolonic continent urinary reservoir, have been performed occasionally at this Institution. Our Phsyco-Oncology Department aided patients concerning learning to live under the new condition of life as an exenterate patient.


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