Adenocarcinoma of the uterine cervix: Lack of evidence for a poor prognosis

Grigsby, Perry W.; Pérez, Carlos A.; Kuske, Robert R.; Camel, H. Marvin; Kao, Ming‐Shian; Galakatos, Andrew E.; Hederman, Mary Ann

doi:10.1016/0167-8140(88)90018-7

Cited by 81 publications

(53 citation statements)

References 21 publications

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“…As we know, clinically, AC patients in early stages (I-IIA) could be cured by radical hysterectomy (RH), whereas the optimal radiotherapy protocol for AC patients with locally advanced stage or inoperable tumor did not reach a conclusion [11]. It was recognized that response to treatment was one of the independent prognostic factors in AC patients [28]. Persistent residual lesions associate with poor survival.…”

Section: Discussionmentioning

confidence: 98%

Combination of external beam radiotherapy and Californium (Cf)-252 neutron intracavity brachytherapy is more effective in control of cervical squamous cell carcinoma than that of cervical adenocarcinoma

et al. 2015

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The objective of this study was to compare the effect of combined external beam radiotherapy (EBRT) and Californium (Cf)-252 neutron intracavity brachytherapy (ICBT) on cervical squamous versus adenocarcinoma. A total of 106 patients with stage IB-IIIB cervical cancer were accrued between January 2005 and May 2011 and divided into squamous cell carcinoma (SCC) and adenocarcinoma (AC) as a pair with 53 patients in each group according to tumor size, stage, age, and hemoglobin level using matched-pair design. The whole pelvic EBRT was performed with 2 Gy/fraction, 4 fractions/week. The total dose was 48-54 Gy (the center of whole pelvic field was blocked by 4 cm in width after 20-36 Gy). Cf-252 neutron ICBT was delivered with 11 and 12 Gy-eq/f with the total dose at point A of 44 and 48 Gy-eq for SCC and AC patients, respectively. The mean follow-up time was 43 months. The 5-year LC, OS, DFS, LAC rates, and mean survival time were 66.0, 56.6, 52.8.0, 17.0%, and 76.4 ± 6.2 months, respectively, for AC patients, whereas they were 81.1, 69.8, 67.9, 11.3%, and 93.3 ± 4.3 months, respectively, for SCC patients. Furthermore, the early treatment toxicity was mild in both groups, the late treatment complications were mainly radiation-induced proctitis and cystitis, and there were no grade 3 or higher complications. Although the combination of Cf-252 neutron ICBT and EBRT was effective in both histology types of cervical cancer, a more aggressive strategy is needed to control cervical AC.

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Section: Discussionmentioning

confidence: 98%

Combination of external beam radiotherapy and Californium (Cf)-252 neutron intracavity brachytherapy is more effective in control of cervical squamous cell carcinoma than that of cervical adenocarcinoma

et al. 2015

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“…[12][13][14] Peters et al, in Gynecologic Oncology Group (GOG) 109/Southwest Oncology Group [SWOG] 8797, found that patients with AC or AS tumors treated with radiation alone had a worse progression-free survival, but that with the addition of chemotherapy, this difference in prognosis for patients with squamous versus nonsquamous cervical tumors disappeared. 30 Perhaps some of the underlying differences between squamous and nonsquamous tumors contributes to the differences observed for mean SUV max among the cervical tumor histologies.…”

Section: Discussionmentioning

confidence: 99%

“…Over the years, there has been some debate regarding the prognostic significance of tumor histology for cervical cancer, with some studies suggesting adenocarcinomas have a worse outcome, [9][10][11] whereas other studies have shown no difference based on histology. [12][13][14] FDG uptake has been shown to correlate with tumor proliferation rates, reflecting tumor aggressiveness in many types of cancer, including lymphoma, nonsmall cell lung cancer (NSCLC), esophageal cancer, and head and neck cancer. 9,[15][16][17][18][19] For NSCLC in particular, FDG uptake has been shown to be significantly different for adenocarcinoma versus squamous cell carcinoma and for well-differentiated versus poorly differentiated tumors.…”

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confidence: 99%

Cervical cancer histology and tumor differentiation affect ¹⁸F‐fluorodeoxyglucose uptake

Kidd

Spencer

Huettner

et al. 2009

Cancer

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BACKGROUND: This study aimed to evaluate the variation in cervical cancer glucose metabolism for different tumor histologies and levels of differentiation, as measured by the uptake of 18F‐fluorodeoxyglucose (FDG) by positron emission tomography (PET). METHODS: The study population consisted of 240 patients with International Federation of Gynecology and Obstetrics stages Ib1 through IVb cervical cancer, who underwent a pretreatment FDG‐PET. Tumor histology included 221 squamous cell (SC), 4 adenosquamous (AS), and 15 adenocarcinoma (AC) tumors. There were 14 well, 145 moderately, and 81 poorly differentiated tumors. The stage distribution was as follows: 70 stage I tumors (9 AC, 2 AS, and 59 SC), 102 stage II tumors (3 AC, 1 AS, and 98 SC), 64 stage III tumors (3 AC, 1 AS, and 60 SC), and 4 stage IV tumors (4 SC). From the FDG‐PET, maximal standardized uptake value (SUVmax) was determined. The variation in SUVmax was analyzed for differences based on tumor histology and differentiation. RESULTS: For all patients, the mean SUVmax was 11.62 (range, 2.50‐50.39). The mean SUVmax by histology was as follows: SC, 11.91 (range, 2.50‐50.39); AS, 8.85 (range, 6.53‐11.26); and AC, 8.05 (range, 2.83‐13.92). Squamous versus nonsquamous tumors demonstrated a significant difference in SUVmax (P = .0153). SUVmax and tumor volume were not found to be correlated (R2 = 0.013). The mean SUVmax was 8.58 for well‐differentiated, 11.56 for moderately differentiated, and 12.23 for poorly differentiated tumors. The mean SUVmax was significantly different for well‒differentiated versus poorly differentiated cervical tumors (P = .0474). CONCLUSIONS: Cervical tumor FDG uptake varied by histology and differentiation. SC tumors demonstrated a significantly higher SUVmax compared with nonsquamous cell tumors, and poorly differentiated tumors also had a higher SUVmax. Cancer 2009. © 2009 American Cancer Society.

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“…However, the 5-year survival rate is 40 to 60%. [17][18][19] That rate indicates that some tumors respond to irradiation therapy effectively and some do not. If we could predict early which patients will not respond to conventional irradiation therapy, another treatment modality, possibly recently developed, effective, chemotherapeutic regimens, could be employed as an alternative.…”

Section: Discussionmentioning

confidence: 99%

Detection of Apoptosis and Expression of Apoptosis‐associated Proteins as Early Predictors of Prognosis after Irradiation Therapy in Stage IIIb Uterine Cervical Cancer

Yuki

Fujimura

Yamakawa

et al. 2000

Japanese Journal of Cancer Research

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We investigated the proportion of apoptotic cells and the expression of apoptosis-associated proteins after the delivery of the first week of irradiation for stage IIIb uterine cervical cancer. Thirty patients with stage IIIb squamous cell carcinoma of the uterine cervix who received only irradiation therapy were registered in this study. Specimens were obtained before irradiation therapy and at the end of the first week of irradiation. The apoptotic index (AI) of each tissue specimen was calculated by counting the apoptotic cells and expressed as a percentage. Immunohistochemical evaluation for apoptosis-related proteins, p53, Bcl-2, Bax, caspase-1 and caspase-3 was also performed. The AI was 0.8 ± ± ± ±0.9% (mean ± ± ± ± SD) before irradiation and 1.7 ± ± ± ±1.3% at the end of the first week of irradiation. We observed that the patients who survived more than 5 years had AI levels of 2.1 ± ± ± ±1.3% at the end of their first week of therapy. This rate was significantly higher than the rate of 1.1 ± ± ± ±0.8% (P = = = =0.02) of the patients who died within 5 years. When the cut-off value of the AI was set at 1.7%, the sensitivity, specificity, positive predictive value, and negative predictive value for the prediction of patients' prognosis after irradiation therapy were 73.4%, 72.4%, 82.4%, and 61.5%, respectively. In 17 of the AI-positive cases, expressions of Bax (P = = = =0.006), caspase-1 (P = = = =0.045), and caspase-3 (P = = = =0.013) at the end of the first week were significantly higher than before irradiation. The proportion of apoptotic cells and the expression of apoptosis-associated proteins, Bax, caspase-1, and caspase-3, at the end of the first week of irradiation could be useful predictors of the prognosis in stage IIIb squamous cell carcinoma of the uterine cervix treated by irradiation therapy.

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Adenocarcinoma of the uterine cervix: Lack of evidence for a poor prognosis

Cited by 81 publications

References 21 publications

Combination of external beam radiotherapy and Californium (Cf)-252 neutron intracavity brachytherapy is more effective in control of cervical squamous cell carcinoma than that of cervical adenocarcinoma

Combination of external beam radiotherapy and Californium (Cf)-252 neutron intracavity brachytherapy is more effective in control of cervical squamous cell carcinoma than that of cervical adenocarcinoma

Cervical cancer histology and tumor differentiation affect ¹⁸F‐fluorodeoxyglucose uptake

Detection of Apoptosis and Expression of Apoptosis‐associated Proteins as Early Predictors of Prognosis after Irradiation Therapy in Stage IIIb Uterine Cervical Cancer

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Adenocarcinoma of the uterine cervix: Lack of evidence for a poor prognosis

Cited by 81 publications

References 21 publications

Combination of external beam radiotherapy and Californium (Cf)-252 neutron intracavity brachytherapy is more effective in control of cervical squamous cell carcinoma than that of cervical adenocarcinoma

Combination of external beam radiotherapy and Californium (Cf)-252 neutron intracavity brachytherapy is more effective in control of cervical squamous cell carcinoma than that of cervical adenocarcinoma

Cervical cancer histology and tumor differentiation affect 18F‐fluorodeoxyglucose uptake

Detection of Apoptosis and Expression of Apoptosis‐associated Proteins as Early Predictors of Prognosis after Irradiation Therapy in Stage IIIb Uterine Cervical Cancer

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Cervical cancer histology and tumor differentiation affect ¹⁸F‐fluorodeoxyglucose uptake