Clinical efficacy of paclitaxel/cisplatin as an adjuvant chemotherapy for patients with cervical cancer who underwent radical hysterectomy and systematic lymphadenectomy

Hosaka, Masayoshi; Watari, Hidemichi; Kato, Tatsuya; Odagiri, Tetsuji; Konno, Yosuke; Endo, Daisuke; Mitamura, Takashi; Kikawa, Satomi; Suzuki, Yoshihiro; Sakuragi, Noriaki

doi:10.1002/jso.22136

Cited by 52 publications

(65 citation statements)

References 17 publications

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“…Therefore, systemic treatment is better for AC histology, and our results suggest that adjuvant CT might be more effective than RT/ CCRT for patients with AC. Several other studies have also shown that adjuvant CT might have some advantages over RT/CCRT regarding treatment-related complications (19,20).…”

Section: Discussionmentioning

confidence: 96%

Adjuvant therapy after radical surgery for stage IB–IIB cervical adenocarcinoma with risk factors

Seki

Tanabe

Nagata

et al. 2016

Jpn. J. Clin. Oncol.

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Objective: Patients with adeno/adenosquamous carcinoma may have a poorer prognosis than patients with squamous cell carcinoma. Radiotherapy and concurrent chemoradiotherapy are used as adjuvant therapies for cervical cancer, regardless of the histological subtype. The aim of this study was to investigate the prognostic outcome of adjuvant therapy for patients with adeno/ adenosquamous carcinoma with pathological risk factors. Methods: The medical records of 135 patients with stage IB-IIB cervical cancer with squamous cell carcinoma or adeno/adenosquamous carcinoma who underwent primary surgery followed by adjuvant therapy were retrospectively reviewed. Patients with a pathologically confirmed bulky tumor (≥4 cm), nodal metastasis and/or parametrium invasion were included in the study. Results: The median follow-up period was 48 (1-132) months. Of the 135 patients, 90 with squamous cell carcinoma and 23 with adeno/adenosquamous carcinoma were treated with adjuvant radiotherapy and concurrent chemoradiotherapy (SCC-RT/CCRT and AC-RT/CCRT groups), and 22 with adeno/adenosquamous carcinoma were treated with adjuvant systemic chemotherapy (AC-CT group). There were no significant differences in clinicopathological factors between the SCC-RT/CCRT and AC-RT/CCRT groups and between the AC-RT/CCRT and AC-CT groups. Progression-free survival was significantly shorter in the AC-RT/CCRT group compared to the SCC-RT/CCRT group (P = 0.002). Adeno/adenosquamous carcinoma histology and multiple lymph node metastasis were independent prognostic factors for shorter progression-free survival in patients treated with adjuvant radiotherapy and concurrent chemoradiotherapy. Progression-free survival was also significantly shorter in the AC-RT/CCRT group compared to the AC-CT group (P = 0.026). Conclusions: Adjuvant radiotherapy and concurrent chemoradiotherapy may be less effective for patients with adeno/adenosquamous carcinoma than for those with squamous cell carcinoma. Adjuvant systemic chemotherapy may be beneficial for adeno/adenosquamous carcinoma and further studies are warranted.

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Section: Discussionmentioning

confidence: 96%

Adjuvant therapy after radical surgery for stage IB–IIB cervical adenocarcinoma with risk factors

Seki

Tanabe

Nagata

et al. 2016

Jpn. J. Clin. Oncol.

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“…In the Cochrane Review, Rosa et al recently reported that the addition of platinum-based chemotherapy to adjuvant radiotherapy may improve survival in women with early-stage cervical cancer and reduce the risk factors for recurrence (20). Another study by Hosaka et al revealed that postoperative chemotherapy using paclitaxel/cisplatin may be more beneficial for survival than adjuvant radiotherapy and could reduce postoperative complications for cervical cancer patients who are treated with radical hysterectomy (21).…”

Section: Discussionmentioning

confidence: 99%

“…In patients with paraaortic lymph node metastasis, 45 Gy of paraaortic radiotherapy was added. In cases with surgical margins that were close to the vagina, 21 Gy of high-dose vaginal brachytherapy was applied in 3 fractions. Vaginal brachytherapy was applied 0.5 cm below the vaginal mucosa, and the upper 4 cm of the vagina was treated.…”

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confidence: 99%

Does lymph node involvement affect the patterns of recurrence in stage IB cervical cancer?

Üreyen¹,

Aksoy²,

Dündar³

et al. 2014

Turk J Med Sci

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IntroductionCarcinoma of the cervix uteri is the second most common cancer and the third most common cause of cancer deaths in women worldwide (1,2). The definitive primary treatment for patients with early-stage disease consists of radiation therapy or radical hysterectomy with pelvic and/ or paraaortic lymph node dissection (3). Knowledge about prognosis and recurrence is critical for the management of early-stage cervical cancer. Lymph node involvement is an important risk factor for recurrence in patients with earlystage cervical cancer. The recurrence rate in lymph nodenegative patients was 10% and the 5-year survival rate ranged from 85%-90%. In contrast, the recurrence rate in lymph node-positive patients was 27% and the 5-year survival rate ranged from 20% to 74% depending on the number of nodes that were involved and the location and size of the metastases (4-6).In this retrospective study, we analyzed the variations in the recurrence patterns of stage IB cervical cancer according to lymph node involvement. These data may improve the management of early-stage cervical cancer to reduce the risk of recurrence and predict the recurrence patterns of early-stage cervical cancer. Materials and methodsThe medical records of patients diagnosed with stage IB cervical cancer and who were treated with type III radical hysterectomy, bilateral salpingo-oophorectomy, or systemic pelvic and paraaortic lymphadenectomy from January 1993 to December 2007 were evaluated retrospectively. The complete pathological data of 170 patients were evaluated. Patients who received neoadjuvant chemotherapy were excluded because chemotherapy is known to improve surgical pathological results (7).All of the patients were evaluated by rectovaginal examination under general anesthesia, computerized tomography of the upper abdomen and pelvic magnetic resonance imaging, or intravenous pyelography. Clinical Background/aim: To investigate the variations in the recurrence patterns of stage IB cervical cancer according to lymph node involvement. Materials and methods:We reviewed the medical records of 170 patients who had undergone type III radical hysterectomy and systematic lymphadenectomy from 1993 to 2007.Results: Among the patients in the study group, 115 did not have lymph node metastases, whereas 55 did. A total of 27 patients developed recurrences. Twelve were in the lymph node-negative group, and 15 were in the lymph node-positive group. The recurrence rate was higher in lymph node-positive group (27.3% versus 10.4%, P = 0.011). The recurrence pattern was not affected by lymph node involvement. However, distant recurrence was more common in the lymph node-positive group (53.3% versus 25%, P = 0.137). Additionally, distant failure was observed only in the patients in the lymph node-negative group who received adjuvant radiotherapy. In this group, 3 patients who did not receive adjuvant radiotherapy developed recurrences only in the pelvic region. Conclusion:The presence of lymph node involvement in stage IB cervical cancer does not affec...

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“…The 3-year overall survival was 93.8 % with TP versus 69.4 % with RT ( p = 0.02). The authors concluded that postoperative chemotherapy using TP may have a survival benefi t compared to adjuvant RT for patients with early-stage disease, along with reduced postoperative complications [ 7 ]. Japanese investigators reported similar results using adjuvant chemotherapy after radical hysterectomy for intermediate-and high-risk stage IB-IIA cervical cancer [ 8 ].…”

Section: What Is the Evidence For Adjuvant Chemotherapy After Surgery?mentioning

confidence: 95%

What Is the Role of Cytotoxic Chemotherapy in Advanced Cervical Cancer?

Pant

Susumu

Toita

et al. 2013

Controversies in the Management of Gynecological Cancers

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Clinical efficacy of paclitaxel/cisplatin as an adjuvant chemotherapy for patients with cervical cancer who underwent radical hysterectomy and systematic lymphadenectomy

Abstract: Postoperative chemotherapy using TP might be more beneficial for survival than adjuvant RT and can reduce postoperative complications for cervical cancer patients treated with radical hysterectomy.

Cited by 52 publications

References 17 publications

Adjuvant therapy after radical surgery for stage IB–IIB cervical adenocarcinoma with risk factors

Adjuvant therapy after radical surgery for stage IB–IIB cervical adenocarcinoma with risk factors

Does lymph node involvement affect the patterns of recurrence in stage IB cervical cancer?

What Is the Role of Cytotoxic Chemotherapy in Advanced Cervical Cancer?

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