scholarly journals Efficacy of the Treatment of Intraperitoneal Bladder Perforation during Transurethral Resection of Bladder Tumor with the Urethral Catheter Alone: Retrospective Analysis of over 15 Years Using the Clinical Data Warehouse System

2021 ◽  
pp. 1-9
Author(s):  
Junghoon Lee ◽  
Jungyo Suh ◽  
Chang Wook Jeong ◽  
Cheol Kwak ◽  
Hyeon Hoe Kim ◽  
...  
Keyword(s):  
Data Warehouse ◽  
Bladder Tumor ◽  
Matched Control ◽  
Foley Catheter ◽  
Progression Free Survival ◽  
Urethral Catheter ◽  
Recurrence Free Survival ◽  
Pelvic Radiotherapy ◽  
Free Survival ◽  
Clinical Data Warehouse

<b><i>Introduction:</i></b> We investigated the efficacy of a urethral catheter alone for intraperitoneal perforation during transurethral resection of bladder tumor (TURBT). <b><i>Patients and Methods:</i></b> We retrospectively evaluated the medical records of 4,543 patients who underwent TURBT from January 2000 to December 2017 using the Clinical Data Warehouse system. The clinicopathologic characteristics, recurrence-free survival, and progression-free survival were compared between the patient groups with intraperitoneal perforation treated with the Foley catheter alone, extraperitoneal perforation, and matched control TURBT. <b><i>Results:</i></b> Intraperitoneal perforation and extraperitoneal perforation were observed in 16 (35.6%) and 29 (64.4%) patients, respectively. In the intraperitoneal perforation group, 11 (68.8%), 2 (12.5%), and 3 (18.8%) patients were treated with the Foley catheter alone, additional percutaneous drainage, and delayed open surgery, respectively. The use of the Foley catheter alone in patients with intraperitoneal perforation of smaller size than the cystoscope or no pelvic radiotherapy history showed improved efficacy without sequelae or therapeutic delay. One of the 2 patients with the size of the intraperitoneal perforation larger than the cystoscope was successfully treated with the Foley catheter alone, whereas the other patient underwent delayed surgical repair. There was no difference in recurrence-free survival and progression-free survival of the intraperitoneal perforation treated with the Foley catheter alone compared to those of the matched control TURBT (<i>p</i> = 0.909, <i>p</i> = 0.518) and the extraperitoneal perforation (<i>p</i> = 0.458, <i>p</i> = 0.699). <b><i>Conclusions:</i></b> Intraperitoneal perforation rarely occurred during TURBT. In the case of intraperitoneal perforation of size smaller than cystoscopy or without pelvic radiotherapy history, treatment with the Foley alone showed successful improvement and safe oncological results. Therefore, treatment with the urethral catheter alone can be carefully considered when an intraperitoneal perforation smaller than the cystoscope size or without pelvic radiotherapy history occurs.

Is intraperitoneal bladder perforation during the transurethral resection of the bladder tumors treatable with urethral catheter alone?: Retrospective analysis over 15 years using the Clinical Data Warehouse (CDW) system (Preprint)

2020 ◽  
Author(s):  
Junghoon Lee ◽  
Jungyo Suh ◽  
Chang Wook Jeong ◽  
Cheol Kwak ◽  
Hyeon Hoe Kim ◽  
...  
Keyword(s):  
Data Warehouse ◽  
Transurethral Resection ◽  
Surgical Repair ◽  
Urethral Catheter ◽  
Bladder Tumors ◽  
Invasive Treatment ◽  
Free Survival ◽  
Non Invasive ◽  
Clinical Data Warehouse ◽  
And Control

BACKGROUND Despite the current medical trend of non-invasive treatment, open surgical repair is the gold standard for intraperitoneal perforation during the transurethral resection of the bladder tumors (TURBT). Efforts have been made to attempt non-invasive treatment, but few studies have been reported. Because intraperitoneal perforation rarely occurs, it is difficult to collect a cohort group. In this case, Clinical Data Warehouse (CDW) system is being used for data analysis for diseases management by extracting data of specific conditions from accumulated electronic health record (EHR). OBJECTIVE We investigated the clinical experience of non-invasive treatment including urethral catheter-alone treatment for bladder perforations during TURBT, especially in cases of intraperitoneal perforations (IPP). METHODS Total 4543 TURBT patients were retrospectively analyzed using the CDW system from January 2000 to December 2017. After extracting the patient with the keywords 'perforation', 'perforated', ‘fat’, 'distension', ‘extravasation’ and 'leakage' from the surgical record using CDW, extracted patients record was reviewed. After dividing the type of perforation into the extraperitoneal perforation (EPP) and the IPP, the clinicopathologic characteristics, treatment methods, clinical course, recurrence-free survival (RFS) and progression-free survival (PFS) were analyzed in the IPP patients treated with Foley alone and were compared to EPP and control TURBT groups. RESULTS IPP was observed in 16 cases (35.6%) and EPP in 29 cases (64.4%). In the IPP group, 11 (68.8%) patients were treated with Foley alone, two (12.5%) with additional percutaneous drainage, and three (18.8%) with delayed open surgery. The Foley alone in the IPP group improved without sequelae or therapeutic delay. Only one of two cases of IPP larger than the cystoscopy was accomplished with Foley alone treatment, and the other underwent delayed surgical repair. There were no differences in RFS and PFS in the Foley alone of IPP group compared to the EPP (p=0.45, p=0.69) and control TURBT groups (p=0.90, p=0.51). CONCLUSIONS It was presented that the intraperitoneal bladder perforation during the TURBT showed a low rate. In smaller intraperitoneal perforation than the cystoscopy size, urethral catheter alone treatment did not show any specific complications and the oncological outcomes were not significantly different. So, the urethral catheter alone treatment can be considered carefully when small IPP occurs.

scholarly journals Restaging Transurethral Resection of Bladder Tumours after BCG Immunotherapy Induction in Patients with T1 Non-Muscle-Invasive Bladder Cancer Might not Be Associated with Oncologic Benefit

2020 ◽  
Vol 9 (10) ◽  
pp. 3306
Author(s):  
Wojciech Krajewski ◽  
Marco Moschini ◽  
Łukasz Nowak ◽  
Sławomir Poletajew ◽  
Andrzej Tukiendorf ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Tertiary Care ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Recurrence Free Survival ◽  
Muscle Invasive Bladder Cancer ◽  
Free Survival ◽  
Muscle Invasive ◽  
Bladder Tumours

Background and Purpose: The European Association of Urology guidelines recommend restaging transurethral resection of bladder tumours (reTURB) 2–6 weeks after primary TURB. However, in clinical practice some patients undergo a second TURB procedure after Bacillus Calmette-Guérin immunotherapy (BCG)induction. To date, there are no studies comparing post-BCG reTURB with the classic pre-BCG approach. The aim of this study was to assess whether the performance of reTURB after BCG induction in T1HG bladder cancer is related to potential oncological benefits. Materials and Methods: Data from 645 patients with primary T1HG bladder cancer treated between 2001 and 2019 in 12 tertiary care centres were retrospectively reviewed. The study included patients who underwent reTURB before BCG induction (Pre-BCG group: 397 patients; 61.6%) and those who had reTURB performed after BCG induction (Post-BCG group: 248 patients, 38.4%). The decision to perform reTURB before or after BCG induction was according to the surgeon’s discretion, as well as a consideration of local proceedings and protocols. Due to variation in patients’ characteristics, both propensity-score-matched analysis (PSM) and inverse-probability weighting (IPW) were implemented. Results: The five-year recurrence-free survival (RFS) was 64.7% and 69.1% for the Pre- and Post-BCG groups, respectively, and progression-free survival (PFS) was 82.7% and 83.3% for the Pre- and Post-BCG groups, respectively (both: p > 0.05). Similarly, neither RFS nor PFS differed significantly for a five-year period or in the whole time of observation after the PSM and IPW matching methods were used. Conclusions: Our results suggest that there might be no difference in recurrence-free survival and progression-free survival rates, regardless of whether patients have reTURB performed before or after BCG induction.

The Result of Re-Transurethral Resection of Bladder Tumor in Eight Years

2021 ◽  
Vol 104 (9) ◽  
pp. 1411-1414
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumor ◽  
Residual Tumor ◽  
Pathology Report ◽  
Detrusor Muscle ◽  
Incomplete Resection ◽  
High Grade ◽  
Recurrence Free Survival ◽  
Minor Complication ◽  
Free Survival

Objective: To analyses the residual tumor and staging after transurethral resection of bladder tumor (TURBT). Moreover, to analyze the recurrence and free survival patients who received treatment by re-transurethral resection of bladder tumor (RE-TURBT) and their complications. Materials and Methods: A retrospective study from 35 patients operated by RE-TURBT between January 2010 and December 2018 was done. The patients in the present study were qualified by 1) incomplete resection from the first TURBT, 2) the detrusor muscle did not appear in specimen for high grade transition cell carcinoma, 3) any T1 lesion, or 4) large or multifocal lesion. The analysis of the residual tumor included staging, recurrence-free survival, and complication after RE-TURBT from the pathology report and follow up method. Results: Thirty-five patients were included in this study. The average age of the patients operated by RE-TURBT was 69 years old, with a range of 44 to 87 years old. The presenting symptom was hematuria with gross hematuria in 28 patients (80%) and microhematuria in seven patients (20%). Twenty-five patients (71.4%) were male. The relative factor was smoking in 23 patients (65%) and coexisting with irritative voiding symptom in 11 patients (31.4%). The present study found that there was incomplete resection in 11 patients (31.4%), with under-staging in five patients and incomplete resection in six patients. There were 14 months recurrence-free survival and minor complication in RE-TURBT patients. Conclusion: One third of the patients operated by RE-TURBT had unreasonable staging, especially in Ta high grade staging. This could change the treatment in two patients (5.7%), which found minor complication from RE-TURBT, and improve recurrence-free survival. Keywords: Transurethral resection of bladder tumor (TURBT); Re Transurethral resection of bladder tumor (Re-TURBT)

Radical Cystectomy in the Treatment of Invasive Bladder Cancer: Long-Term Results in 1,054 Patients

2001 ◽  
Vol 19 (3) ◽  
pp. 666-675 ◽  
Author(s):  
John P. Stein ◽  
Gary Lieskovsky ◽  
Richard Cote ◽  
Susan Groshen ◽  
An-Chen Feng ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Radical Cystectomy ◽  
Bladder Tumor ◽  
Invasive Bladder Cancer ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Node Negative ◽  
Primary Bladder

PURPOSE: To evaluate our long-term experience with patients treated uniformly with radical cystectomy and pelvic lymph node dissection for invasive bladder cancer and to describe the association of the primary bladder tumor stage and regional lymph node status with clinical outcomes. PATIENTS AND METHODS: All patients undergoing radical cystectomy with bilateral pelvic iliac lymphadenectomy, with the intent to cure, for transitional-cell carcinoma of the bladder between July 1971 and December 1997, with or without adjuvant radiation or chemotherapy, were evaluated. The clinical course, pathologic characteristics, and long-term clinical outcomes were evaluated in this group of patients. RESULTS: A total of 1,054 patients (843 men [80%] and 211 women) with a median age of 66 years (range, 22 to 93 years) were uniformly treated. Median follow-up was 10.2 years (range, 0 to 28 years). There were 27 (2.5%) perioperative deaths, with a total of 292 (28%) early complications. Overall recurrence-free survival at 5 and 10 years for the entire cohort was 68% and 66%, respectively. The 5- and 10-year recurrence-free survival for patients with organ-confined, lymph node–negative tumors was 92% and 86% for P0 disease, 91% and 89% for Pis, 79% and 74% for Pa, and 83% and 78% for P1 tumors, respectively. Patients with muscle invasive (P2 and P3a), lymph node–negative tumors had 89% and 87% and 78% and 76% 5- and 10-year recurrence-free survival, respectively. Patients with nonorgan-confined (P3b, P4), lymph node–negative tumors demonstrated a significantly higher probability of recurrence compared with those with organ-confined bladder cancers (P < .001). The 5- and 10-year recurrence-free survival for P3b tumors was 62% and 61%, and for P4 tumors was 50% and 45% , respectively. A total of 246 patients (24%) had lymph node tumor involvement. The 5- and 10-year recurrence-free survival for these patients was 35%, and 34%, respectively, which was significantly lower than for patients without lymph node involvement (P < .001). Patients could also be stratified by the number of lymph nodes involved and by the extent of the primary bladder tumor (p stage). Patients with fewer than five positive lymph nodes, and whose p stage was organ-confined had significantly improved survival rates. Bladder cancer recurred in 311 patients (30%) . The median time to recurrence among those patients in whom the cancer recurred was 12 months (range, 0.04 to 11.1 years). In 234 patients (22%) there was a distant recurrence, and in 77 patients (7%) there was a local (pelvic) recurrence. CONCLUSION: These data from a large group of patients support the aggressive surgical management of invasive bladder cancer. Excellent long-term survival can be achieved with a low incidence of pelvic recurrence.

scholarly journals Impact of immunohistochemistry-based molecular subtype on predicting chemotherapy response and survival in patients with T1 stage bladder cancer after bladder-preserving treatment

2020 ◽  
Author(s):  
Jiangli Lu ◽  
Yijun Zhang ◽  
Chenyan Wu ◽  
Chengbiao Chu ◽  
Zhuowei Liu ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Molecular Subtypes ◽  
Progression Free Survival ◽  
Intravesical Chemotherapy ◽  
Chemotherapy Response ◽  
Recurrence Free Survival ◽  
Luminal A ◽  
Free Survival ◽  
Luminal B ◽  
T1 Stage

Abstract Objective To explore the immunohistochemistry-based molecular subtypes of bladder cancer, and their impact on the prognosis and the chemotherapy response between gemcitabine plus cisplatin intra-arterial chemotherapy and epirubicin-inducted intravesical chemotherapy, in patients with T1 stage bladder cancer after bladder-preserving treatment. Methods One hundred and seventy-six patients with T1 stage bladder cancer were selected for this study. Thirty-three patients underwent radical cystectomy, 43 received gemcitabine plus cisplatin intra-arterial chemotherapy and 100 received intravesical chemotherapy. The markers labeled with luminal (GATA3, Uroplakin II, CK20) and basal (CK5/6, CK14, CD44) phenotypes were chosen as candidate markers. Results One hundred and seventy-six patients were divided into 76 patients as basal/squamous (BASQ), 45 as the luminal A and 55 as the luminal B. Compared with the luminal B and BASQ tumors, the luminal A tumors showed a trend for better recurrence-free survival (P = 0.105) and progression-free survival (P = 0.093). The combination of CK20 and GATA3 was practical to identify the molecular phenotypes with total 84.9% accuracy and significantly associated with recurrence-free survival (P = 0.025) and progression-free survival (P = 0.004). The patient with BASQ tumors who received intravesical chemotherapy showed a trend for worse progression-free survival than the patient who received gemcitabine plus cisplatin intra-arterial chemotherapy or radical cystectomy. Furthermore, the patients with BASQ tumors experienced a significant improvement in progression-free survival after gemcitabine plus cisplatin intra-arterial chemotherapy compared with the patients who received intravesical chemotherapy (P = 0.011). Conclusions The immunohistochemistry-based molecular subtypes could predict the patient’s prognosis and clinically different chemotherapeutic survival outcomes in patients with T1 stage bladder cancer after bladder-preserving treatment.

scholarly journals Prognostic value of prostate volume in non-muscle invasive bladder cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Won Sik Ham ◽  
Jee Soo Park ◽  
Won Sik Jang ◽  
Young Deuk Choi ◽  
Jongchan Kim
Keyword(s):  
Bladder Cancer ◽  
Prostate Volume ◽  
Progression Free Survival ◽  
Invasive Bladder Cancer ◽  
Intravesical Therapy ◽  
Recurrence Free Survival ◽  
Muscle Invasive Bladder Cancer ◽  
Free Survival ◽  
Muscle Invasive ◽  
Group 1

AbstractThere is evidence that a history of benign prostatic hyperplasia increases the incidence of bladder cancer, and treatment with 5-alpha reductase inhibitor or androgen deprivation therapy reduces recurrence of non-muscle invasive bladder cancer. We aimed to evaluate whether prostate volume affects its prognosis. We reviewed medical records of men who underwent transurethral resection of bladder tumor due to non-muscle invasive bladder cancer from January 2012 to December 2017. Patients were divided into two groups based on prostate volume measured by computed tomography (group 1: 264 patients with ≤ 30 mL, group 2: 124 patients with > 30 mL). Propensity score matching analysis was used for adjust selection bias, and then assessed recurrence-free survival and progression-free survival. With a median follow up duration of 52 months, group 1 showed higher 5-year recurrence-free and progression-free survival (69.3% vs 47.0%, p = 0.001; 96.7% vs 87.7%, p = 0.002). Further, cox-regression analysis showed that tumor size (HR = 1.292 p < 0.001), multifocal tumor (HR = 1.993, p < 0.001), adjuvant intravesical therapy (chemotherapy: HR = 0.580, p = 0.037 and bacillus Calmette–Guérin: HR = 0.542, p = 0.004) and prostate volume (HR = 2.326, p < 0.001) were significant predictors of recurrence-free survival. Prostate volume (HR = 2.886, p = 0.014) was also associated with PFS with age (HR = 1.043, p = 0.044) and tumor grade (HR = 3.822, p = 0.013). We conclude higher prostate volume is associated with worse recurrence and progression-free survival in non-muscle invasive bladder cancer.

Early vs Delayed Radical Cystectomy Compared in Highgrade Superficial Bladder Tumors

2009 ◽  
Vol 76 (2) ◽  
pp. 83-86 ◽  
Author(s):  
V. Varca ◽  
A. Simonato ◽  
M. Esposito ◽  
A. Curotto ◽  
M. Orlandini ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radical Cystectomy ◽  
Bladder Tumor ◽  
Progression Free Survival ◽  
Intravesical Therapy ◽  
Close Monitoring ◽  
Bladder Tumors ◽  
Free Survival ◽  
Muscle Invasive ◽  
Group B

Objectives The treatment of aggressive superficial TCC of the bladder remains controversial. In fact, although still classified as ‘superficial’, it has been shown that the biological characteristics of T1G3 bladder tumors are the same as those of the muscle-invasive group (T2 and above). Even with close monitoring and intensive intravesical therapy, the reported risk of muscle invasion in these patients is 53% and 1/3 die from this disease in the long-term. The aim of this study is to determine whether the timing of radical cystectomy affects the survival of patients with aggressive superficial bladder tumor. Methods We consider 74 patients who underwent radical cystectomy between November 1994 and October 2006 before a diagnosis of T1G3 bladder tumor. These patients were divided in 2 subgroups: group A (n=27, 25 M and 2 F) who underwent immediate radical cystectomy, and group B (n=47, 40 M and 7 F) who underwent other conservative treatments before radical cystectomy. Results The two subgroups were similar concerning age (66.29±8.37 yrs vs 66.87±8.6 yrs, respectively, p NS) and the timing of follow-up (respectively 77±45 vs 60±35 mths, p NS). Moreover, the progression-free survival was significantly higher in subgroup A (53.73±48.54 vs 31.94±35.19 mths, log-rank p<0.05) as well as the overall survival (59.73±45.37 vs 36.45±33.96 mths respectively, log-rank p<0.05). Comparing the histological examinations, the two subgroups were significantly different concerning the T stage (superficial tumors 14/27 vs 16/47, respectively, p<0.05; invasive tumors 13/27 vs 31/47, respectively, p<0.00005) and the lymphonodal dissemination (2N+/27 vs 11N+/47, respectively, p<<0.0005). Conclusions Delaying radical cystectomy for aggressive superficial bladder tumors leads to a worse progression-free survival; the overall survival is likely to be due also to an early lymphonodal dissemination, which occurs extending the timing between diagnosis and radical treatment.

scholarly journals Potential Influence of the Anesthetic Technique Used during Open Radical Prostatectomy on Prostate Cancer-related Outcome

2010 ◽  
Vol 113 (3) ◽  
pp. 570-576 ◽  
Author(s):  
Patrick Y. Wuethrich ◽  
Shu-Fang Hsu Schmitz ◽  
Thomas M. Kessler ◽  
George N. Thalmann ◽  
Urs E. Studer ◽  
...  
Keyword(s):  
Overall Survival ◽  
Epidural Analgesia ◽  
General Anesthesia ◽  
Biochemical Recurrence ◽  
Progression Free Survival ◽  
Anesthetic Technique ◽  
Recurrence Free Survival ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Thoracic Epidural

Background Recently published studies suggest that the anesthetic technique used during oncologic surgery affects cancer recurrence. To evaluate the effect of anesthetic technique on disease progression and long-term survival, we compared patients receiving general anesthesia plus intraoperative and postoperative thoracic epidural analgesia with patients receiving general anesthesia alone undergoing open retropubic radical prostatectomy with extended pelvic lymph node dissection. Methods Two sequential series were studied. Patients receiving general anesthesia combined with epidural analgesia (January 1994-June 1997, n=103) were retrospectively compared with a group given general anesthesia combined with ketorolac-morphine analgesia (July 1997-December 2000, n=158). Biochemical recurrence-free survival, clinical progression-free survival, cancer-specific survival, and overall survival were assessed using the Kaplan-Meier technique and compared using a multivariate Cox-proportional-hazards regression model and an alternative model with inverse probability weights to adjust for propensity score. Results Using propensity score adjustment with inverse probability weights, general anesthesia combined with epidural analgesia resulted in improved clinical progression-free survival (hazard ratio, 0.45; 95% confidence interval, 0.27-0.75, P=0.002). No significant differences in the two groups were found for biochemical recurrence-free survival, cancer-specific survival, or overall survival. Higher preoperative serum values for prostate-specific antigen, specimen Gleason score of at least 7, non-organ-confined tumor stage, and positive lymph node status were independent predictors of biochemical recurrence-free survival. Conclusions General anesthesia with epidural analgesia was associated with a reduced risk of clinical cancer progression. However, no significant difference was found between general anesthesia plus postoperative ketorolac-morphine analgesia and general anesthesia plus intraoperative and postoperative thoracic epidural analgesia in biochemical recurrence-free survival, cancer-specific survival, or overall survival.

Efficacy and safety of laterally extended endopelvic resection for the pelvic side wall gynecologic tumors: A four-year prospective cohort study with historical comparison.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6092-6092
Author(s):  
Haerin Paik ◽  
Soo Jin Park ◽  
Hee Seung Kim ◽  
Jae-Weon Kim
Keyword(s):  
Cervical Cancer ◽  
Palliative Chemotherapy ◽  
Recurrent Disease ◽  
Progression Free Survival ◽  
Recurrence Free Survival ◽  
Efficacy And Safety ◽  
Recurrent Cervical Cancer ◽  
Free Survival ◽  
Historical Comparison ◽  
Laterally Extended Endopelvic Resection

6092 Background: Although laterally extended endopelvic resection (LEER) has been introduced to control the pelvic sidewall tumors, there is a lack of evidence about its efficacy and safety despite high skillful procedure, compared with the other treatments. Thus, we performed a prospective cohort study with historical comparison for four years. Methods: One gynecologic oncologist performed LEER consecutively for patients with the pelvic sidewall tumors between March 2014 and July 2018. We compared clinicopathologic characteristics and survival between patients who received primary LEER and with those treated with other treatments. Results: We enrolled 37 patients treated with LEER. Among them, 22 (59.5%) and 15 (40.5%) had recurrent and primary disease. Among perioperative outcomes, there was more estimated blood loss, and hospitalization was longer in recurrent disease and previous surgery (p < 0.05). In recurrent disease, previous progression-free survival < 8 months was related to poor recurrence-free survival after LEER (median, 5.4 vs. 10.2 months; p < 0.05). When LEER was applied for the first recurrence of cervical cancer, recurrence-free survival and overall survival after treatment seemed to be longer in LEER (n = 9) than in palliative chemotherapy (n = 27) without statistical significance (median, 12.2 vs. 4.7 months and 23.2 vs. 12.4 months; p = 0.13 and p = 0.63). In 15 patients with primary locally advanced cervical cancer, LEER after partial response to neoadjuvant chemotherapy showed longer progression-free survival than LEER after stable or progressive disease to neoadjuvant chemotherapy and primary radiotherapy (p = 0.012). After LEER, grade 3 and 4 complications developed in 15 (23.1%) and 2 (3.1%) patients. Conclusions: Compared with palliative chemotherapy, LEER followed by palliative chemotherapy may improve progression-free survival in patients with recurrent cervical cancer located in the pelvic sidewall. If possible, it is more effective to apply LEER without preceding palliative chemotherapy for recurrent cervical cancer located in the pelvic sidewall.

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