Bone recurrence after radical hysterectomy and lymphadenectomy in early-stage cervical cancer/Erken donem servikal kanserde radikal histerektomi ve lenfadenektomi sonrasi kemik nuksu

• Published in: Turkish journal of obstetrics and gynecology 2019-12, Vol.16 (4), p.266
• Main Authors: Cakir, Caner, Yuksel, Dilek, Kilic, Cigdem, Unsal, Mehmet, Dur, Riza, Boyraz, Gokhan, Karalok, Alper, Tekin, Ozlem Moraloglu, Turan, Taner
• Format: Article
• Language: English
• Subjects: Cervical cancer; Hysterectomy; Recurrence (Disease); Surgery; Women's health
• ISSN: 2149-9322
• DOI: 10.4274/tjod.galenos.2019.26932

Objective: To present the clinical, surgical, and pathologic features of bone recurrence in patients who underwent radical hysterectomy for early-stage uterine cervical cancer. Materials and Methods: Data of 412 patients who underwent type III radical hysterectomy and pelvic [+ or -] paraaortic lymphadenectomy for stage 1B-2A epithelial cervical cancer were reviewed. Seven (1.7%) patients with bone recurrence in the first recurrence were included in the study. Results: The median follow-up of the main cohort (n=412) was 46 (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 recurrence ranged from 9 to 45 months. Of the recurrences, five were in the axial skeleton and two were in the appendicular skeleton. Recurrence was observed in lumbar vertebrae in three patients, thoracic vertebrae in one patient, sacral vertebrae in one patient, lumbosacral vertebrae in one patient, and the left femur in two patients. Four patients had multiple recurrence in 3 patients despite isolated bone recurrence. Patients with multiple recurrences died within 6-25 months. All isolated bone recurrences were in the axial skeleton. Complete clinical response with salvage therapy was achieved in two 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. Keywords: Bone recurrence, uterine cervical cancer, survival, salvage therapy Amac: Erken evre uterin servikal kanser icin radikal histerektomi yapilan hastalarda kemik nuksunun klinik, cerrahi ve patolojik ozelliklerini sunmayi amacladik. Gerec ve Yontemler: Evre 1B-2A epitelyal servikal kanser icin tip 3 radikal histerektomi ve pelvik [+ or -] paraaortik lenfadenektomi uygulanan 412 hastanin verileri gozden gecirildi. Calismaya ilk nuksde kemik nuksu olan 7 hasta (%1,7) dahil edildi. Bulgular: Ana kohortun ortanca takip suresi (n=412) 46 aydi (1-300 ay). Bu donemde, 53 hastada (%12,9) nuks gelisti ve bu nukslerin %13,2'sinde (53) 7'sinde kemikte nuks gozlendi. Nuks zamani 9 ila 45 ay arasinda degismekteydi. Nukslerin 5'i aksiyal iskelet, 2'si apendikuler iskeletteydi. Uc hastada lomber vertebra, 1 hastada torasik vertebra, 1 hastada sakral vertebra, 1 hastada lumbosakral omur ve 2 hastada sol femur saptandi. Dort hastada izole kemik nuksune ragmen 3 hastada coklu nuks vard