Radical hysterectomy with adequate dissection of areas of possible metastasis in locally advanced cervical cancer


DOI: https://dx.doi.org/10.18565/pharmateca.2021.11.70-76

G.A. Khakimov (1, 2), B.B. Negmadzhanov (3), G.G. Khakimova (1, 2), M.N. Tashmetov (1), Kh.U. Musurmonov (1, 2), Sh.G. Khakimova (1, 4), Sh.Sh. Kadyrov (1, 2), Sh.T. Usmanova (1, 2)

1) Department of Oncology, Pediatric Oncology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan; 2) Tashkent City Branch of the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology, Tashkent, Uzbekistan; 3) Department of Obstetrics and Gynecology № 2, Samarkand State Medical Institute, Samarkand, Uzbekistan; 4) Moscow Research Institute of Oncology n.a. P.A. Herzen – branch of the National Medical Research Center of Radiology, Moscow, Russia
Background. Using modern chemotherapy regimens, elements of aggressive oncosurgery in gynecological oncology, it is possible to achieve an increase in the number of cured patients with locally advanced cervical cancer (CC), providing an improvement in the immediate and long-term results of treatment. The proposed method of surgical treatment is the method of choice for the surgical treatment of patients with locally advanced cervical cancer (IIA-IIIB stage).
Objective. Introduction of the method of surgical treatment of IIA – IIIB stage cervical cancer into clinical practice.
Methods. Long-term results of treatment of 155 patients with morphologically verified IIA – IIIB stage cervical cancer were analyzed. Patients received neoadjuvant chemotherapy (NACT) (n=110) and chemoradiation therapy (CRT) (n=45). After achievement of resectability, the patients underwent surgical treatment using a new technique. Overall survival (OS) and progression-free survival (PFS) outcomes were assessed.
Results. In the period from 2017 to 2020, 155 patients with IIA – IIIB stage cervical cancer after NACT (n=110) and CRT (n=45) underwent combined radical hysterectomy according to our patented method. The most frequent postoperative complications were urinary disorders in 67 (60.9%) and 19 (42.2%) patients, lymphatic cysts in 20 (18.2%) and 10 (22.2%) and vesicovaginal fistula in 5 (4.6%) and 2 (4.4%) patients, respectively. According to the results of pathomorphological examination, the most frequent tumor response to NACT was grade III therapeutic pathomorphosis (TP) in 44 patients (40%) of group 1 and grade IV TP in 21 patients, accounting for 46.6%. The median follow-up was 28.7 (3.6 to 51.1) months. During this time, 30 patients died in both groups (17 [15.5%] and 13 [28.9%]), (P=0.047). Disease progression occurred in 16 (10.3%) patients (6 [5.5%] and 10 [22.2%]) (P=0.004), respectively. The 3-year OS was 83.8±3.7 and 71.0±6.8% (P=0.131), PFS–- 93.5±2.6 and 77.7±6.6% (P=0.006 ).
Conclusion. The proposed method of surgical treatment of IIA – IIIB stage cervical cancer has a novelty and can be used in practical medicine for surgical treatment of cervical cancer.

About the Autors


Corresponding author: Gulnoz G. Khakimova, Cand. Sci. (Med.), Teaching Assistant at the Department of Oncology, Pediatric Oncology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan; hgg_doc@mail.ru; ORCID: https://orcid.org/0000-0002-4970-5429


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