Radiation therapy with and without extrafascial hysterectomy for bulky stage IB cervical carcinoma: a randomized trial of the Gynecologic Oncology Group
June 1, 2003
Does an adjuvant hysterectomy after RT improve survival for women with bulky stage IB cervical cancer?
total RT - 8000cGy to point A (EBRT - 4000cGy, intracavitary - 4000cGy) and 5500cGy to point B
total RT - 7500cGy to point A (EBRT - 4500cGy, intracavitary - 3000cGy) and 5500cGy to point Bextrafascial hysterectomy (no parametria removed), BSO+/- lymphadenectomy
bulky stage IB cervical cancer (≥4cm)squamous, adenosquamous, adenocarcinoma
RT only (n=124) vs RT/surgery (n=132):grade 3/4 adverse events: 10% vs 10%median f/u time: 9.6 yrsrecurrence: 46% vs 37% (NS)death: 44% vs 42% (NS)
The addition of an adjuvant hysterectomy does not improve survival in women with bulky stage IB cervical cancer