{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:49:19Z","timestamp":1784126959090,"version":"3.55.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To investigate the safety of concurrent chemoradiotherapy after Type 3 radical hysterectomy, focusing on non-hematologic toxicity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Between January 2010 and December 2017, 236 patients diagnosed with cervical cancer Stages IB1\u2013II (FIGO2008) and who had undergone Type 3 radical hysterectomy at the Jikei Medical University School-related four hospitals were included. Of these 236 patients, 134 had undergone adjuvant concurrent chemoradiotherapy after Type 3 radical hysterectomy (radical hysterectomy + concurrent chemoradiotherapy group), and 102 received no adjuvant therapy after Type 3 radical hysterectomy (radical hysterectomy group). The frequency of non-hematologic toxicities, especially lymphedema, pelvic infection, renal dysfunction, ileus and diarrhea, was investigated in the radical hysterectomy + concurrent chemoradiotherapy and radical hysterectomy groups using univariate and multivariate analyses. In these analyses, age, extent of lymph node dissection and preoperative clinical stage were included as risk factors for five complications. The risk factors for grade \u2264 2 adverse events were statistically evaluated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The frequency of lower extremity lymphedema (22 vs. 10%), renal dysfunction (13 vs. 3%), and diarrhea (13 vs. 0%) was significantly higher in the radical hysterectomy + CRRT group than that in the radical hysterectomy group. Logistic regression analysis revealed that adjuvant concurrent chemoradiotherapy significantly affected the occurrence of grade \u2265 2 lymphedema (P &amp;lt; 0.01) and renal dysfunction (P &amp;lt; 0.01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Concurrent chemoradiotherapy after Type 3 radical hysterectomy is associated with a higher incidence of renal dysfunction, lower extremity lymphedema and diarrhea. A more appropriate adjuvant therapy needs to be established.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jjco\/hyac211","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T13:30:14Z","timestamp":1674048614000},"page":"393-400","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of non-hematologic toxicity in patients with cervical cancer after Type 3 radical hysterectomy followed by concurrent chemoradiotherapy: a retrospective study"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6764-8459","authenticated-orcid":false,"given":"Motoaki","family":"Saito","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Jikei University School of Medicine , Tokyo , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Jikei University School of Medicine , Tokyo , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kishihito","family":"Yamauchi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Jikei University School of Medicine , Tokyo , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Jikei University School of Medicine , Tokyo , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6465-7883","authenticated-orcid":false,"given":"Hirokuni","family":"Takano","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Jikei University School of Medicine , Tokyo , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyosuke","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Jikei University School of Medicine , Tokyo , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikou","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Jikei University School of Medicine , Tokyo , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,18]]},"reference":[{"key":"2023050106124520300_ref1","author":"ICO\/IARC Information Centre on HPV and Cancer (HPV Information Centre)","year":"2019"},{"key":"2023050106124520300_ref2","volume-title":"Cancer Registry and Statistics","author":"National Cancer Center, Cancer Control and Information Center"},{"key":"2023050106124520300_ref3","volume-title":"NCCN Guidelines","author":"NCCN Cervical Cancer (Version 1. 2018)"},{"key":"2023050106124520300_ref4","first-page":"172","article-title":"Types of radical hysterectomies: from Thoma Ionescu and Wertheim to present day","volume":"7","author":"Marin","year":"2014","journal-title":"J Med Life"},{"key":"2023050106124520300_ref5","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1007\/s00292-005-0762-5","article-title":"New concepts for surgical therapy of cervical carcinoma","volume":"26","author":"H\u00f6ckel","year":"2005","journal-title":"Pathologe"},{"key":"2023050106124520300_ref6","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/j.1525-1438.2007.01016.x","article-title":"Original film of the Okabayashi\u2019s radical hysterectomy by Okabayashi himself in 1932, and two films of the precise anatomy necessary for nerve-sparing Okabayashi\u2019s radical hysterectomy clarified by Shingo Fujii","volume":"18","author":"Fujii","year":"2008","journal-title":"Int J Gynecol Cancer"},{"key":"2023050106124520300_ref7","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1093\/annonc\/mdp196","article-title":"Quality assurance for radical hysterectomy for cervical cancer: the view of the European Organization for Research and Treatment of Cancer\u2013Gynecological Cancer Group (EORTC-GCG)","volume":"20","author":"Verleye","year":"2009","journal-title":"Ann Oncol"},{"key":"2023050106124520300_ref8","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.ygyno.2015.01.548","article-title":"Clinical tumor diameter and prognosis of patients with FIGO stage IB1 cervical cancer (JCOG0806-A)","volume":"137","author":"Kato","year":"2015","journal-title":"Gynecol Oncol"},{"key":"2023050106124520300_ref9","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/jjco\/hyu168","article-title":"Non-randomized confirmatory trial of modified radical hysterectomy for patients with tumor diameter 2cm or less FIGO StageIB1 uterine cervical cancer: Japan Clinical Oncology Group study (JCOG1101)","volume":"45","author":"Kunieda","year":"2015","journal-title":"Jpn J Clin Oncol"},{"key":"2023050106124520300_ref10","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1006\/gyno.2000.6010","article-title":"Class II versus class III radical hysterectomy in stage IB-IIA cervical cancer: a prospective randomized study","volume":"80","author":"Landoni","year":"2001","journal-title":"Gynecol Oncol"},{"key":"2023050106124520300_ref11","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.ygyno.2007.06.015","article-title":"Clinical-pathologic and morbidity analyses of types 2 and 3 abdominal radical hysterectomy for cervical cancer","volume":"107","author":"Pikaart","year":"2007","journal-title":"Gynecol Oncol"},{"key":"2023050106124520300_ref12","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ygyno.2007.08.076","article-title":"Anatomic identification and functional outcomes of the nerve sparing Okabayashi radical hysterectomy","volume":"107","author":"Fujii","year":"2007","journal-title":"Gynecol Oncol"},{"key":"2023050106124520300_ref13","doi-asserted-by":"crossref","first-page":"e41","DOI":"10.3802\/jgo.2018.29.e41","article-title":"Oncologic effectiveness of nerve-sparing radical hysterectomy in cervical cancer","volume":"29","author":"Ditto","year":"2018","journal-title":"J Gynecol Oncol"},{"key":"2023050106124520300_ref14","volume-title":"Treatment Guidelines for Cervical Cancer","author":"Japan Society of Gynecologic Oncology","year":"2017"},{"key":"2023050106124520300_ref15","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1200\/JCO.2000.18.8.1606","article-title":"Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix","volume":"18","author":"Peters","year":"2000","journal-title":"J Clin 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