Abstract
Introduction: Fast growing cervix carcinomas have a pejorative outcome: they may occur quickly
after cervical smears qualified as normal – within an interval from 12 to 18 months
in women less than 50 years old, and involveing the endocervix. This retrospective
analysis is aimed at assessing 5-year outcomes. Materials and methods: Twenty cases of fast-growing cancer of the uterine cervix classified according to
the FIGO clinical staging system as IB (n=14), IIA (3), and IIB (3), have been reviewed and compared to a cohort of 160 cases
not having this feature. As regard to fast-growing carcinoma, the median age was 41
years (range 25–50), and the median follow-up 22 months (8–213) as compared to 54
years (27–79) and 80 months (5–199) for the reference cohort. The comparison of the
two cohorts shows only a difference of breakdown which concerns the histological pelvic
lymph nodes status (P<0.05), more often positive in fast-growing forms. The treatment policy was equally
distributed between a radio-surgical approach, cesium 137 intracavitary irradiation
followed by radical hysterectomy and lymphadenectomy, or a definitive irradiation
with pelvic external irradiation followed by cesium 137 intracavitary irradiation.
Results: Thirteen deaths are reported in the fast-growing series instead of 54 in the other
series. The 5-year overall survival is, respectively, 34 (13–55) vs. 74% (68–82) (P<0.001), the loco-regional-free survival 58 (33–84) vs. 85% (79–81) (P<0.001), the 5-year metastasis-free survival 61 (38–84) vs. 84% (78–90) (P=0.004). Conclusion: These poor results emphasize the need to intensify loco-regional therapy with a
concurrent cisplatin-based chemotherapy within the framework of a multidisciplinary
approach.
Keywords
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Article info
Publication history
Accepted:
August 2,
1999
Received:
February 13,
1999
Identification
Copyright
© 2000 Elsevier Science Ireland Ltd. Published by Elsevier Inc. All rights reserved.
