Late Urological Complications and Malignancies After Curative Radiotherapy for Gynecological Carcinomas: A Retrospective Analysis of 10,709 Patients

No AccessJournal of UrologyClinical Urology: Original Articles1 Sep 1997Late Urological Complications and Malignancies After Curative Radiotherapy for Gynecological Carcinomas: A Retrospective Analysis of 10,709 Patients Ulrich Maier, Peter M. Ehrenbock, and Johann Hofbauer Ulrich MaierUlrich Maier More articles by this author , Peter M. EhrenbockPeter M. Ehrenbock More articles by this author , and Johann HofbauerJohann Hofbauer More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64325-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: A retrospective study was done to analyze late urological complications following curative radiotherapy of primary gynecological carcinomas. All patients were treated at a single center and with the same radiotherapeutic regimen. The incidence of other carcinomas in these patients was also evaluated. Materials and Methods: A total of 10,709 patients was treated using combined telebrachytherapy (dosage 67.5 Gy.) during an observation period of 22 years. Results: Severe late complications were seen in 1.24% (133 of 10,709) of the patients, including irradiated bladder (65 cases, mean interval since treatment 6.7 years), ureteral stenosis (33, mean 5.7 years) and urinary fistula (35, mean 2.7 years). Complications required surgery in 118 of 133 patients with a perioperative mortality of 4.2% (5 of 118). Overall in 4.27% (457 of 10,709) of the patients another malignancy developed after (29.1%), during (26.3%) and before (44.6%) radiotherapy. Subsequent malignancies after treatment were predominantly seen in the genital region (88.4%) but they were also in the irradiated nongenital area (0.13%, 14 of 10,709). Of the latter patients 6 had urothelial bladder cancer, which represents a relative risk of 4.66 (based on the Austrian female population) to develop bladder cancer after radiotherapy for gynecological cancer. Conclusions: Late urological complications after radiotherapy of the pelvis are rare but severe. Surgical therapy of irradiated tissues has a higher complication rate compared to surgery on nonirradiated tissue. References 1 : Radical pelvic surgery versus radiation therapy for stage I carcinoma of the cervix (exclusion of microvasion).. Amer. J. Obst. Gynec.1976; 126: 785. Google Scholar 2 : Ulceration of the urinary bladder as a late effect of radium applications to the uterus.. J.A.M.A.1927; 89: 1121. Google Scholar 3 : Complications in the urinary tract due to carcinoma of the uterine cervix or radiation treatment.. Amer. J. Urogenol.1930; 24: 47. Google Scholar 4 : The effect of carcinoma of the cervix uteri and its treatment upon the urinary tract.. Amer. J. Obst. 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Google Scholar From the Departments of Urology and Gynecological Radiology, University of Vienna, Vienna, Austria.© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited bySchumacher M, Scholz M, Weise E, Fleischmann A, Thalmann G and Studer U (2018) Is There an Indication for Frozen Section Examination of the Ureteral Margins During Cystectomy for Transitional Cell Carcinoma of the Bladder?Journal of Urology, VOL. 176, NO. 6, (2409-2413), Online publication date: 1-Dec-2006.NEULANDER E, RIVERA I, EISENBROWN N and WAJSMAN Z (2018) SIMPLE CYSTECTOMY IN PATIENTS REQUIRING URINARY DIVERSIONJournal of Urology, VOL. 164, NO. 4, (1169-1172), Online publication date: 1-Oct-2000.POMEROY B, KEIM L and TAYLOR R (2018) PREOPERATIVE HYPERBARIC OXYGEN THERAPY FOR RADIATION INDUCED INJURIESJournal of Urology, VOL. 159, NO. 5, (1630-1632), Online publication date: 1-May-1998. Volume 158Issue 3September 1997Page: 814-817 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.Metrics Author Information Ulrich Maier More articles by this author Peter M. Ehrenbock More articles by this author Johann Hofbauer More articles by this author Expand All Advertisement PDF downloadLoading ...