Prospective multicenter study on urologic complications after radical surgery with or without radiotherapy in the treatment of stage IB-IIA cervical cancer

A national collaborative group has conducted a multicenter prospective stud y on the use of a specific glossary for the complications associated with t he treatment of cervical cancer, which were analytically described in 1989. This report analyzes the urologic complications with particular reference to radical surgery in stage IB-IIA cancer cases. In the prospective multice nter clinical study 2024 patients with frankly invasive cervical cancer wer e enrolled (IB = 1041; IIA = 308; IIB = 384; IIIA-B = 237; IV = 54). This r eport considers 1349 patients with stage IB-IIA disease. Treatment modaliti es in this group of patients were: type III radical surgery in 21.9%; type III radical surgery followed by radiotherapy in 20.8%; type III radical sur gery preceded by radiotherapy in 7.3%; type II radical surgery in 3.1%; typ e II radical surgery followed by radiotherapy in 8.4%; type II radical surg ery preceded by radiotherapy in 18.8%; surgery plus chemotherapy plus radio therapy in 3.5%; radiotherapy alone in 16%. In this case series 873 complic ations were registered, and among these 341 (39.1%) were described in the u rinary tract. Among 277 bladder complications 47.3% were grade 1; 47.3% gra de 2, and 5.4% grade 3. Among 64 ureter complications 59.4% were grade 1; 1 7.2% grade 2, and 23.4% grade 3. Distribution of severe urinary complicatio ns was different according to site (bladder or ureter) and treatment modali ties (radical surgery alone: bladder 1.3%, ureter 1.3%; radical surgery fol lowed by radiotherapy: 1.4% bladder, 2.8% ureter; radical surgery preceded by radiotherapy: 3% bladder, 0% ureter). Different distributions of severe urinary complication were also observed in respect to stage (IB vs IIA); tr eatment: elective vs nonelective. In 673 patients treated with radical surg ery plus or minus radiotherapy 123 relapses were registered (18.2%). Incide nce of relapse was not different in patients suffering from mild/severe com plications vs patients without complications. Disease-free survival, death from tumor, and death from other causes were not different in the group wit h complications in comparison to the group without complications.