NN Alexandrov National Cancer Center of Belarus, Belarus
Title: Pelvic Artery Embolization in Patients with Cervical Cancer Complicated by Hemorrhage: Single-Institution Experience in Belarus
Matylevich research and clinical interests evolve around treatment and prevention of cervical cancer. In 2008 Belarus implemented NCI clinical treatment guidelines for cervical cancer. Her research interests include epidemiology and statistical analysis of cervical cancer treatment outcomes following introduction of NCI treatment protocols. She is interested in standardization of National clinical protocols according to International treatments guidelines and she is interested in opportunities provided by International cancer research networks. She is interested in translational research and how it leads to meaningful health outcomes in the field of gynecologic oncology, particularly treatment of cervical cancer. She has been also included in the team of expert responsible for development and implementation of National Screening Program for gynecological cancers.
To investigate the efficacy of pelvic artery embolization (PAE) in patients with locally advanced and recurrent cervical cancer (CC) complicated by hemorrhage. Methods: A retrospective study was performed of consecutive 81 patients: 68 (84%) with primary locally advanced CC and 13 (16%) with recurrent disease. Results: The PAE controlled the hemorrhage in 76 (94%) patients. After successful embolization, 46 of 68 (68%) primary CC patients, started antineoplastic treatment and 29 of these women (43%) subsequently completed primary treatment. During the follow-up period, 67 (83%) patients died of disease, and 4 (5%) died of other causes. The adjusted one-year survival was 41.4% (SE 5.6%), five-year survival was 17.9% (SE 4.5%), and median adjusted survival was 8.4 months. Survival of the 22 (32%) patients who did not receive further treatment, and 46 (68%) patients who continued the treatment was significantly different, with a one-year adjusted survival of 15.2% (SE 8.1%) and 53.5% (SE 7.4%), respectively. None of the patients without further treatment survived 5 years whereas in the group undergoing further treatment, the 5-year-adjusted survival was 24.0% (SE 6.8%), and the median adjusted survival was 5.4 months and 12.8 months respectively (Ñ€ <0.001). Conclusions: PAE was effective in controlling hemorrhage in 94% of patients with locally advanced and recurrent CC. Sixty-eight percent of patients were able to undergo further antitumor treatment. PAE is a minimally invasive intervention that can be effective at any stage of treatment in patients with CC preventing with hemorrhage.