Extended and combined surgery for gynecological cancer

Abstract

Objective: The amount of patients in St.-Petersburg, Russia primarily diagnosed for local and advanced gynecological cancer is annually increasing. 5-year survival rate in stage IV changes in depend on sites of lesion from 10 to 15% and in stage III does not exceed 20%. The aim of the study to analyze the results of the treatment of those patients.

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Methods: We analyzed the data from 146 patients underwent combined surgery, that was 3,1% from all women who received surgical treatment in the department of gynecological oncology since 1987 till 1997 for cervical, endometrial and ovarian cancer.

Results: The mostly often revealed sites of extension of the disease were rectum (22,8%), small intestine (22,8%), sigmoid intestine (21,8%), cecum (12,3%), urea excretory system (8,8%). 12,3% of patients had several sites of lesions. In 60,2% cases the bowel obstruction was developed. Including of extended and combined surgery in to the clinical practice for local and advanced women’s genital malignancies allowed to increase resectability for last decade 8,5-fold. Postoperative mortality rare was 10,9%. The use of this treatment modalities showed 66% rate of cumulative 3-year survival and 55,3% 5-year survival.

Conclusion: Thus, introduction of active surgery tactics in combination with radiation and adjuvant chemotherapy shows the significant improvement in treatment outcome.