Preoperative irradiation therapy and radical hysterectomy
prognostic value of tumor regression after initial irradiation of squamous cell carcinoma of the cervix
Palavras-chave:
Squamous cell, Cervical cancer, Cervix uteri, Hysterectomy, Radiotherapy, Multivariate AnalysisResumo
OBJETIVO: Investigar o papel da persistência do tumor em pacientes submetidos a radioterapia e histerectomia radial. TIPO DE ESTUDO: Estudo retrospectivo de fatores prognósticos. LOCAL: Hospital A.C. Camargo da Fundação Antônio Prudente, São Paulo, Brasil. PARTICIPANTES: Um total de 629 casos de carcinoma espinocelular do colo do útero foram estudados, entre 1953 e 1982. PROCEDIMENTOS: As pacientes foram submetidas à cirurgia radical e radioterapia, separadamente ou em combinação. VARIÁVEIS ESTUDADOS: Análise Multivariada das diferentes variáveis envolvidas foi realizada de acordo com o método regressivo de Cox. RESULTADOS: As variáveis de valor prognóstico foram, em ordem de importância: a década de admissão das pacientes, a modalidade de terapêutica empregada, a presença de tumor residual na peça operatória e o estado clínico da doença. A década de admissão foi de valor prognóstico significante. A presença de doença residual na peça operatória foi mais importante do que o envolvimento linfonodal, embora a sobrevida geral das pacientes tenha sido afetada pelo aumento no número de linfonodos comprometidos. CONCLUSÃO: O tratamento radioterápico esteriliza um considerável número de linfonodos, mas não todos e em todas as pacientes. Existe um específico grupo de pacientes cuja cirurgia radical é necessária para um completo controle da doença.
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