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Objectives. Invasive cervical cancer that is discovered only after si mple hyst erectomy remains a problem. Little is known about the best management of this gr oup since there are no relevant outcome studies. This study aimed to quantify th e benefits of guideline-based treatment by comparing outcome data in patients t reated by inappropriate simple hysterectomy and adjuvant radiotherapy with data in patients treated with primary radical surgery, radiotherapy, or radiochemothe rapy. Methods. Records of 288 patients who had undergone radical hysterectomy wi th pelvic lymphadenectomy or simple hysterectomy were extracted and divided into three groups -radical hysterectomy alone (n = 89), radical hysterectomy and ad juvant radiotherapy (n = 119), and simple hysterectomy with adjuvant radiotherap y (n = 80). Disease-free and overall survival were calculated using Kaplan-Mei er analyses. Results. There was a trend towards better overall survival in the r adical hysterectomy group. Disease-free survival was significantly better in pa tients treated by radical hysterectomy, followed by simple hysterectomy plus rad iotherapy, and then radical hysterectomy plus radiotherapy (PlogrankDFS < 0.002) . When the two radical surgery groups were combined and compared with the subopt imally treated group, no significant differences were seen for overall survival. Conclusion. Postoperative radiotherapy is a good treatment for patients with ce rvical cancer who have undergone suboptimal simple hysterectomy. Appropriate sel ection criteria for further surgery remain to be defined.
Objectives. Invasive cervical cancer that is discovered only after si mple hyst erectomy remains a problem. Little is known about the best management of this gr oup since there are no relevant outcome studies. This study aimed to quantify th e benefits of guideline-based treatment by comparing outcome data in patients t reated by inappropriate simple hysterectomy and adjuvant radiotherapy with data in patients treated with primary radical surgery, radiotherapy, or radiochemothe rapy. Methods. Records of 288 patients who had undergone radical hysterectomy wi th pelvic lymphadenectomy or simple hysterectomy were extracted and divided into three groups -radical hysterectomy alone (n = 89), radical hysterectomy and ad juvant radiotherapy (n = 119), and simple hysterectomy with adjuvant radiotherap y (n = 80) Kaplan-Mei er analyzes. Results. There was a trend towards better overall survival in the adhine hysterectomy group. Disease- free survival was significantly better in pa tients treated by radical hysterectomy, followed by simple hysterectomy plus radotherapy, and then radical hysterectomy plus radiotherapy (Plogrank DFS <0.002). When the two radical surgery groups were combined and compared with the subopt imally treated group, no significant differences were seen for overall survival. Conclusion Postoperative radiotherapy is a good treatment for patients with ce rvical cancer who have undergone suboptimal simple hysterectomy. Appropriate selction criteria for further surgery remain to be defined.