RADIOLOGICAL ENDOVASCULAR EMBOLIZATION OF SMALL PELVIS ARTERIES IN PATIENTS WITH COMPLICATED UTERINE CERVIX CANCER
Objective. To analyze the efficacy of radiological endovascular embolization of small pelvis arteries in patients with locally advanced and recurrent uterine cervix cancer (UCC) complicated with hemorrhage.
Materials and methods. Eighty one patients were included in the study including 68 (84%) primary patients with locally advanced UCC and 13 (16%) subjects with UCC recurrences underwent radiological endovascular occlusion of small pelvis arteries for bleeding from a cervical tumor.
Results. Arterial embolization resulted in hemorrhage arrest in 76 (94%) patients. After successful radiological endovascular hemostasis in 68% (46 of 68) of primary UCC patients antineoplastic treatment was performed and according to the radical program fully — in 43% (29 of 68) of cases. During the follow-up period, 67 (83%) patients died from the underlying disease, four (5%) persons — from other reasons.
The 1-year adjusted survival (AS) was 41.4% (SE 5.6%), the 5-year survival — 17.9% (SE 4.5%), the median being 8.4 months. Survival rates among 22 (32%) patients not treated further and among 46 (68%) patients continued to get treatment differed significantly both clinically and statistically. The 1-year AS was 15.2% (SE 8.1%) and 53.5% (SE 7.4%), respectively, no patient had survived for 5 years in the first subgroup, in the second subgroup the 5-year AS was 24.0% (SE 6.8%), the median AS for the first subgroup was 5.4 months, for the second — 12.8 months (р<0.001).
Conclusion. Arterial embolization of pelvis vessels is an effective method of arresting hemorrhage in patients with locally advanced and recurrent UCC in 94% of cases. The procedure carried out in primary patients in case of complicated locally advanced UCC allows perform special antitumor treatment in 68% of cases.