- Email: [email protected]
Survival of patients with positive aortic nodes in clinical stage IB and IIA carcinoma of the cervix
ABSTRACTS
OF
SOCIETY
OF
GYNECOLOGIC
ONCOLOGISTS
357
metastasis at 28 months. Survival was evaluated in relation to the clinical status of the aortic nodes at the time of staging laperotomy: clinically negative aortic lyqh mdes but histolcgically positive; single clinically positive aortic xxie biopsied or ccqletely resected: and mltiple aortic nodal rretastases biopsied or ompletely resected. Of the 9 wcmn with clinically negative para-aortic lymph nodes, 2 are surviving WEDover 5 years and 7 are dead (4 dead of disease (COD) and 3 dead of qlications Of tk 6 woman with a single clinically positive aortic node, one patient mc~ mm. is alive over 5 years NED (lyqh node completely resected) and 4 are DODand one Dot NED. All 16 womenwithmultiple aortic nodemtastases are D3D including the 6 patientswho had 100% resection of the multiple para-aortic node n&astases. The majority of these 16 smnen have subsequently developed multiple distant metastases smst likely indicative of subclinical distant metastasis originally. This latter finding plus the high anplication rate fran 6000 rads irradiation has led to the follu&ng plan of managesent for patientswithlocallyadvancedcervicalcancer: worn found tohavemultiple aortic mde metastases should have biopsy confirmation of the metastasis followed by systemic Patients with clinically negative aortic lynph nodes should undergo paratherapy. aortic lynphadenectoq and patients with a single clinically positive aortic node Because of the significant conplication shmldhave thenode ampletelyresected. rate utilizing 6000 rads, such patients with histologic confirmation of aortic node mstastases should receive no greater than 4400 to5000rads in 4-l/2 to 5 weeks.
SURVI~OFPATLENTSWSTHPOSI~~PdlrrrICNODESINQINICALS~~IBANDIIA~~~ R. E. Girtamer, J.H. Ford, Jr., H. E. Averette, Division OF 'IHE CERVIX. S. R. Foliakoff, of Gynecologic Oncology, Depertnent of Obstetrics and Qmcology, University of Miami School of &dicine, Miami, Florida. For the lasttenyears, a surgical staging protocol for the trea~tofcarcinamofthe cervixandenckamatrimhasbeen employedby the Divisionof GynecclogicOncologyatthe University of Miami school of Madicine. As part of this protocol, all surgical exploratiohs werebegunbypara-aorticlynphadenectony-and therapywas individualizedbasedon the operatively determined spread of disease. During this tine, 381 cxmbind cases of early stage carcimmof the cervixand~&mMrimnwhose surgicaltreabnsntbasedon clinical examina tion would have been by radical hysterecbxy with pelvic lynphadenec~ Of these 381 cases, 28 patients were identified at surgery with disease were evaluated. beyond the usual surgical or radiotherapeutic treatment ports. It is the outame of this group of patients with biopsy-proven metastases to the para-aortic nodes that will be the subject of this paper. All patients except one received pelvic plus para-aortic radioYlWenty-two patients withclinicalsta~ IB cervicalcarcinoma were foundto therapy. be surgical stage IV. Fbur of 12 are absolute 5-year survivors while nine of 19 are absolute 3-year survivors. Of four clinical stage IIAcases, threehave diedwithinone year of therapy, and one is nm 12 mnths without evidence of recurrence. !Ihree patients with stage II adenocar cinm of the en&nnetriLxn explored for radical hystere&o my were found to have disease in the para-aortic nodes. Of these, lx0 are alive without disease two year5 after treamt, while one died within 12 months frcxn her tmmr. Of all cases, the absolute 3 and 5-year survival rates of thosewithkncm and treated diseaseinthe para-aortic area are 47% and 33%, respectively.
PREDI~ILITYOF~P~BLAST~ROVrCOMEBASEDON~~CONST1~GN.R. Pattillo, U. Surti, P. Katayam, S. Sasaki, R. Mattingly, S. O'Brien, W. Bcdmr. The ?&dical College of Wisconsin, Milwaukee, Wisconsin; The University of Pittsburgh, Pittsburgh, PA; National Institutes of Health, Bethesda, MD; Imperial Cancer Research Laboratories, Iondon, hgland. Troplmblast disease patients adnitted to this institution have been studied for clmxmscmel Inorder to determinewhichhydatidifommleswill require constitution and HGA types. cytotoxic drug treatment, parentalchmmsane contributions havebeendetemined. Cmplete hydatidifom soles have 46 XX, or rarely 46XY, diploid karyotypes of andmgenetic unlike a nonmlamceptuswhere half the gerrmeismatemalandhalfpaternal, origin.
OF
SOCIETY
OF
GYNECOLOGIC
ONCOLOGISTS
357
metastasis at 28 months. Survival was evaluated in relation to the clinical status of the aortic nodes at the time of staging laperotomy: clinically negative aortic lyqh mdes but histolcgically positive; single clinically positive aortic xxie biopsied or ccqletely resected: and mltiple aortic nodal rretastases biopsied or ompletely resected. Of the 9 wcmn with clinically negative para-aortic lymph nodes, 2 are surviving WEDover 5 years and 7 are dead (4 dead of disease (COD) and 3 dead of qlications Of tk 6 woman with a single clinically positive aortic node, one patient mc~ mm. is alive over 5 years NED (lyqh node completely resected) and 4 are DODand one Dot NED. All 16 womenwithmultiple aortic nodemtastases are D3D including the 6 patientswho had 100% resection of the multiple para-aortic node n&astases. The majority of these 16 smnen have subsequently developed multiple distant metastases smst likely indicative of subclinical distant metastasis originally. This latter finding plus the high anplication rate fran 6000 rads irradiation has led to the follu&ng plan of managesent for patientswithlocallyadvancedcervicalcancer: worn found tohavemultiple aortic mde metastases should have biopsy confirmation of the metastasis followed by systemic Patients with clinically negative aortic lynph nodes should undergo paratherapy. aortic lynphadenectoq and patients with a single clinically positive aortic node Because of the significant conplication shmldhave thenode ampletelyresected. rate utilizing 6000 rads, such patients with histologic confirmation of aortic node mstastases should receive no greater than 4400 to5000rads in 4-l/2 to 5 weeks.
SURVI~OFPATLENTSWSTHPOSI~~PdlrrrICNODESINQINICALS~~IBANDIIA~~~ R. E. Girtamer, J.H. Ford, Jr., H. E. Averette, Division OF 'IHE CERVIX. S. R. Foliakoff, of Gynecologic Oncology, Depertnent of Obstetrics and Qmcology, University of Miami School of &dicine, Miami, Florida. For the lasttenyears, a surgical staging protocol for the trea~tofcarcinamofthe cervixandenckamatrimhasbeen employedby the Divisionof GynecclogicOncologyatthe University of Miami school of Madicine. As part of this protocol, all surgical exploratiohs werebegunbypara-aorticlynphadenectony-and therapywas individualizedbasedon the operatively determined spread of disease. During this tine, 381 cxmbind cases of early stage carcimmof the cervixand~&mMrimnwhose surgicaltreabnsntbasedon clinical examina tion would have been by radical hysterecbxy with pelvic lynphadenec~ Of these 381 cases, 28 patients were identified at surgery with disease were evaluated. beyond the usual surgical or radiotherapeutic treatment ports. It is the outame of this group of patients with biopsy-proven metastases to the para-aortic nodes that will be the subject of this paper. All patients except one received pelvic plus para-aortic radioYlWenty-two patients withclinicalsta~ IB cervicalcarcinoma were foundto therapy. be surgical stage IV. Fbur of 12 are absolute 5-year survivors while nine of 19 are absolute 3-year survivors. Of four clinical stage IIAcases, threehave diedwithinone year of therapy, and one is nm 12 mnths without evidence of recurrence. !Ihree patients with stage II adenocar cinm of the en&nnetriLxn explored for radical hystere&o my were found to have disease in the para-aortic nodes. Of these, lx0 are alive without disease two year5 after treamt, while one died within 12 months frcxn her tmmr. Of all cases, the absolute 3 and 5-year survival rates of thosewithkncm and treated diseaseinthe para-aortic area are 47% and 33%, respectively.
PREDI~ILITYOF~P~BLAST~ROVrCOMEBASEDON~~CONST1~GN.R. Pattillo, U. Surti, P. Katayam, S. Sasaki, R. Mattingly, S. O'Brien, W. Bcdmr. The ?&dical College of Wisconsin, Milwaukee, Wisconsin; The University of Pittsburgh, Pittsburgh, PA; National Institutes of Health, Bethesda, MD; Imperial Cancer Research Laboratories, Iondon, hgland. Troplmblast disease patients adnitted to this institution have been studied for clmxmscmel Inorder to determinewhichhydatidifommleswill require constitution and HGA types. cytotoxic drug treatment, parentalchmmsane contributions havebeendetemined. Cmplete hydatidifom soles have 46 XX, or rarely 46XY, diploid karyotypes of andmgenetic unlike a nonmlamceptuswhere half the gerrmeismatemalandhalfpaternal, origin.