Early Postoperative Outcomes in Patients with Uterine Cervical Cancer

EARLY POSTOPERATIVE OUTCOMES IN PATIENTS WITH UTERINE CERVICAL CANCER (Abstract): BACKGROUND: Uterine cervical cancer still presents high percentages of locally advanced tumors on diagnosis due to the lack of screening programs. The multidisciplinary approach in these cases requires neoadjuvant radio-chemotherapy followed in selected cases by surgery. The aim of this study was the assessment of early postoperative outcomes in a consecutive series of cervical cancer patients. METHODS: We performed a comparative analysis in terms of patients and tumor characteristics, type of surgery and postoperative complications on 83 patients with radical surgery divided in terms of neoadjuvant treatment protocol. Two groups were designed: group A, patients who underwent neoadjuvant therapy (n=38; 45.78%) and group B, patients operated without neoadjuvant therapy (n=45; 54.22%). RESULTS: The patients mean age was 54.1±11.6 years old. Most cases on diagnosis were stage IIB (41 cases, 49.39%) followed by stage IB (24 cases, 28.9%). Neoadjuvant treatment was performed in 38 patients (45.78%) (stage IIA – 1 patient, IIB – 31 patients, IIIA – 1 patient and IIIB – 5 patients), with a complete response in 16 (42.1%). Most common intervention was type II radical hysterectomy with pelvic lymphadenectomy in 54 cases (65%). There was no difference in terms of deep vein thrombosis, postoperative urinary and medical morbidity. Digestive complications were relatively higher in neoadjuvant group (28.94% in group A vs. 6.66% in group B, P=0.008) with a longer hospitalization (8.1±2.7 days for group A vs. 6.6±1.6 for group B, P=0.01). CONCLUSION: Radical hysterectomy is a relatively safe technique in terms of postoperative morbidity for patients with cervical cancer despite the use of neoadjuvant therapy. This provides the chance for cure in early stages and a local control for more advanced cases.