Bone Recurrence after Radical Hysterectomy and Lymphadenectomy in Early Stage Cervical Cancer
Caner Cakir, Dilek Yuksel, Cigdem Kilic, Mehmet Unsal, Rıza Dur, Gokhan Boyraz, Alper Karalok, Ozlem Moraloglu Tekin, Taner TuranEtlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, Gynecologic Oncology DivisionObjective: We aimed to present the clinical, surgical and pathologic features of bone recurrence in patients who underwent radical hysterectomy for early-stage uterine cervical cancer.
Methods: Data of 412 patients who underwent type III radical hysterectomy and pelvic ± paraaortic lymphadenectomy for stage 1B-2A epithelial cervical cancer were reviewed. 7 (1.7%) patients with recurrence of bone in the first recurrence were included in the study.
Results: The median follow-up of the main cohort (n: 412) was 46 months (range, 1-300 months). In this period, recurrence developed in 53 (12.9%) patients and recurrence was observed in bone in 13.2% (7 of 53) of these recurrences. Time to recurrens ranged from 9 to 45 months. Of the recurrences, 5 were in the axial skeleton and 2 were in the appendicular skeleton. Recurrence was observed in lumbar vertebrae in 3 patients, thoracic vertebrae in 1 patient, sacral vertebrae in 1 patient, lumbosacral vertebrae in 1 patient and left femur in 2 patients.4 patients had multiple recurrence in 3 patients despite isolated bone recurrence. Patients with multiple recurrense died within 6-25 months. All of the isolated bone recurrences were in the axial skeleton. Complete clinical response with salvage therapy was achieved in 2 patients with isolated bone recurrence.
Conclusion: Complete clinical response and long postoperative survival can be achieved with salvage treatment when bone recurrence is solitary in cervical cancers.
Erken Donem Servikal Kanserde Radikal Histerektomi ve Lenfadenektomi Sonrası Kemik Nuksu
Caner Cakir, Dilek Yuksel, Cigdem Kilic, Mehmet Unsal, Rıza Dur, Gokhan Boyraz, Alper Karalok, Ozlem Moraloglu Tekin, Taner TuranEtlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Jinekolojik Onkoloji KliniğiAmaç: Erken evre uterin servikal kanser için radikal histerektomi yapılan hastalarda kemik nüksünün klinik, cerrahi ve patolojik özelliklerini sunmayı amaçladık.
Yöntem: Evre 1B-2A epitelyal servikal kanser için tip III radikal histerektomi ve pelvik ± paraaortik lenfadenektomi uygulanan 412 hastanın verileri gözden geçirildi. Çalışmaya ilk nüksde kemik nüksü olan 7 hasta (% 1,7) dahil edildi.
Bulgular: Ana kohortun ortanca takip süresi (n: 412) 46 aydı (1-300 ay). Bu dönemde, 53 hastada (% 12.9) nüks gelişti ve bu nükslerin% 13.2'sinde (53) 7'sinde kemikte nüks gözlendi. Nüks zamanı 9 ila 45 ay arasında değişmekteydi. Nükslerin 5'i aksiyal iskelet, 2'si apendiküler iskeletteydı. 3 hastada lomber vertebra, 1 hastada torasik vertebra, 1 hastada sakral vertebra, 1 hastada lumbosakral omur ve 2 hastada sol femur saptandı.4 hastada izole kemik nüksüne rağmen 3 hastada çoklu nüks vardı. Çoklu nüks olan hastalar 6-25 ay içerisinde öldüler. İzole kemik nükslerinin tümü aksiyal iskelette idi. İzole kemik nüksü olan 2 hastada kurtarma tedavisi ile tam klinik yanıt sağlandı.
Sonuç: Servikal kanserlerde kemik nüksü tek olduğunda, salvage tedavisi ile tam klinik yanıt ve postoperatif uzun sağkalım sağlanabilir.
Corresponding Author: Caner Cakir, Türkiye
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