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Can the Results be Improved by Combining Radiation and Elective Radical Hysterectomy and Lymphadenectomy?

Can the Results be Improved by Combining Radiation and Elective Radical Hysterectomy and... With fewer than 50 stage III patients treated by combined therapy reported in the literature,7-10 the answer to this question can only be speculative. Worldwide five-year survival is 27.2% and even in the best hands, irradiation yields a survival rate of only 33.5%11 Presumably, radiocurability of stage III lesions is limited by tumor radioresistance, the high incidence of lymph node metastases (44%-66%),4 the difficulties of treatment of lesions involving the lower vagina, and the debilitation and lowered host resistance induced by the advanced carcinoma. We would add one further limitation from our experience, that of microscopically unidentifiable tumor nests which persits in a static, almost symbiotic relationship with the host after apparent curative radiotherapy. At a later date, aggressive behavior of these tumor nests may be activated either spontaneously or secondary to lowered host resistance from age, other disease, or disruption of tissues by subsequent surgery. Prompt pelvic http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Can the Results be Improved by Combining Radiation and Elective Radical Hysterectomy and Lymphadenectomy?

JAMA , Volume 193 (13) – Sep 27, 1965

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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.1965.03090130033009
Publisher site
See Article on Publisher Site

Abstract

With fewer than 50 stage III patients treated by combined therapy reported in the literature,7-10 the answer to this question can only be speculative. Worldwide five-year survival is 27.2% and even in the best hands, irradiation yields a survival rate of only 33.5%11 Presumably, radiocurability of stage III lesions is limited by tumor radioresistance, the high incidence of lymph node metastases (44%-66%),4 the difficulties of treatment of lesions involving the lower vagina, and the debilitation and lowered host resistance induced by the advanced carcinoma. We would add one further limitation from our experience, that of microscopically unidentifiable tumor nests which persits in a static, almost symbiotic relationship with the host after apparent curative radiotherapy. At a later date, aggressive behavior of these tumor nests may be activated either spontaneously or secondary to lowered host resistance from age, other disease, or disruption of tissues by subsequent surgery. Prompt pelvic

Journal

JAMAAmerican Medical Association

Published: Sep 27, 1965

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