Why Is Surgery Still Done after Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer in Romania?
The incidence and mortality of cervical cancer are high in Romania compared to other European countries, particularly for locally advanced cervical cancer cases, which are predominant at the time of diagnosis. Widely accepted therapeutic guidelines indicate that the treatment for locally advanced ce...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/2/425 |
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| author | Silviu Cristian Voinea Cristian Ioan Bordea Elena Chitoran Vlad Rotaru Razvan Ioan Andrei Sinziana-Octavia Ionescu Dan Luca Nicolae Mircea Savu Cristina Mirela Capsa Mihnea Alecu Laurentiu Simion |
| author_facet | Silviu Cristian Voinea Cristian Ioan Bordea Elena Chitoran Vlad Rotaru Razvan Ioan Andrei Sinziana-Octavia Ionescu Dan Luca Nicolae Mircea Savu Cristina Mirela Capsa Mihnea Alecu Laurentiu Simion |
| author_sort | Silviu Cristian Voinea |
| collection | DOAJ |
| description | The incidence and mortality of cervical cancer are high in Romania compared to other European countries, particularly for locally advanced cervical cancer cases, which are predominant at the time of diagnosis. Widely accepted therapeutic guidelines indicate that the treatment for locally advanced cervical cancer consists of concurrent chemoradiotherapy (total dose 85–90 Gy at point A), with surgery not being necessary as it does not lead to improved survival and results in significant additional morbidity. In Romania, the treatment for locally advanced cervical cancer differs, involving lower-dose chemoradiotherapy (total dose 60–65 Gy at point A), followed by surgery, which, under these circumstances, ensures better local control. In this regard, we attempted to evaluate the role and necessity of surgery in Romania, considering that in our study, residual lesions were found in 55.84% of cases on resected specimens, especially in cases with unfavorable histology (adenocarcinoma and adenosquamous carcinoma). This type of surgery was associated with significant morbidity (28.22%) in our study. The recurrence rate was 24.21% for operated-on patients compared to 62% for non-operated-on patients receiving suboptimal concurrent chemotherapy alone. In conclusion, in Romania, surgery will continue to play a predominant role until radiotherapy achieves the desired effectiveness for local control. |
| first_indexed | 2024-03-08T11:02:04Z |
| format | Article |
| id | doaj.art-515b2c5df83240d7b13c79d2af0b1a05 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-08T11:02:04Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-515b2c5df83240d7b13c79d2af0b1a052024-01-26T15:38:20ZengMDPI AGCancers2072-66942024-01-0116242510.3390/cancers16020425Why Is Surgery Still Done after Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer in Romania?Silviu Cristian Voinea0Cristian Ioan Bordea1Elena Chitoran2Vlad Rotaru3Razvan Ioan Andrei4Sinziana-Octavia Ionescu5Dan Luca6Nicolae Mircea Savu7Cristina Mirela Capsa8Mihnea Alecu9Laurentiu Simion10“Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaRadiotherapy Department, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, RomaniaRadiology Department, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania“Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaThe incidence and mortality of cervical cancer are high in Romania compared to other European countries, particularly for locally advanced cervical cancer cases, which are predominant at the time of diagnosis. Widely accepted therapeutic guidelines indicate that the treatment for locally advanced cervical cancer consists of concurrent chemoradiotherapy (total dose 85–90 Gy at point A), with surgery not being necessary as it does not lead to improved survival and results in significant additional morbidity. In Romania, the treatment for locally advanced cervical cancer differs, involving lower-dose chemoradiotherapy (total dose 60–65 Gy at point A), followed by surgery, which, under these circumstances, ensures better local control. In this regard, we attempted to evaluate the role and necessity of surgery in Romania, considering that in our study, residual lesions were found in 55.84% of cases on resected specimens, especially in cases with unfavorable histology (adenocarcinoma and adenosquamous carcinoma). This type of surgery was associated with significant morbidity (28.22%) in our study. The recurrence rate was 24.21% for operated-on patients compared to 62% for non-operated-on patients receiving suboptimal concurrent chemotherapy alone. In conclusion, in Romania, surgery will continue to play a predominant role until radiotherapy achieves the desired effectiveness for local control.https://www.mdpi.com/2072-6694/16/2/425locally advanced cervical cancerconcurrent chemoradiotherapyadjuvant surgerylocal controlhigh cervical cancer morbidityresidual disease |
| spellingShingle | Silviu Cristian Voinea Cristian Ioan Bordea Elena Chitoran Vlad Rotaru Razvan Ioan Andrei Sinziana-Octavia Ionescu Dan Luca Nicolae Mircea Savu Cristina Mirela Capsa Mihnea Alecu Laurentiu Simion Why Is Surgery Still Done after Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer in Romania? Cancers locally advanced cervical cancer concurrent chemoradiotherapy adjuvant surgery local control high cervical cancer morbidity residual disease |
| title | Why Is Surgery Still Done after Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer in Romania? |
| title_full | Why Is Surgery Still Done after Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer in Romania? |
| title_fullStr | Why Is Surgery Still Done after Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer in Romania? |
| title_full_unstemmed | Why Is Surgery Still Done after Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer in Romania? |
| title_short | Why Is Surgery Still Done after Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer in Romania? |
| title_sort | why is surgery still done after concurrent chemoradiotherapy in locally advanced cervical cancer in romania |
| topic | locally advanced cervical cancer concurrent chemoradiotherapy adjuvant surgery local control high cervical cancer morbidity residual disease |
| url | https://www.mdpi.com/2072-6694/16/2/425 |
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