Dose Response Relationship and Prognostic Factors of Nodal Control Rate of Metastatic Lymph Nodes in Cervical Cancer

Abstract

without metastatic disease, 22 underwent upfront surgery or radiotherapy followed by adjuvant concurrent chemo-radiotherapy (CCRT) or chemotherapy (the local first group); 7 underwent CCRT or chemotherapy before surgery(NAC group); 12 underwent surgery alone, and the remaining 10 underwent CCRT alone. Chemotherapy was administered to 53 (80%) patients. Among the 53 patients, 37 underwent chemo-regimen for small cell carcinoma (CDDP/CBDCA+VP16 or CPT11), whereas the remaining 16 patients underwent chemo-regimen for advanced cervical cancers (weekly CDDP, CDDP+5FU, DTX+CBDCA). The five-year overall survival for all patients was 52%. More specifically, the five-year overall survival by UICC stage I, II, IIIb, and IV was 64%, 76%, 57%, and 0%, respectively. No significant differences in survival were found by FIGO stage (I-IIa vs ! IIb) or by nodal status after excluding patients with UICC stage IV (pZ0.22 and pZ0.49, respectively). Despite the more advanced disease stage, patients in the NAC group tended to have better survival compared to those in the local first group (100% vs 63%; pZ0.12). The five-year survival rates in the small cell carcinoma chemo-regimen group and the advanced cervical cancer chemo-regimen group were 63% and 17%, respectively (P<0.01), and 80% and 33%, respectively (PZ0.07), when limited to CCRT patients. The same trend was observed regardless of UICC stages. Furthermore, no difference in five-year survival was observed between CDDP/CBDCA+VP16 and CDDP+CPT11. Conclusion: SCCC should be treated as localized small cell carcinoma. The application of chemotherapy before surgery may further improve patient survival.

The Application Value of CT Three-Dimensional Microscope Reconstruction Technology in the Diagnosis of Cervical Cancer

“…The coincidence rate between the results of CT examination and pathological examination in these patients is high. When using spiral CT to examine patients with cervical cancer, the diameter of their lymph nodes can be measured on the cross-section, and then, the shape and location of lymph nodes can be reconstructed [ 25 ]. However, when this method is used to examine patients with cervical cancer, it has poor ability to distinguish the internal structure of lymph nodes and low sensitivity to lymph nodes with metastasis but small volume, especially lymph nodes with a diameter of less than 10 mm.…”

Dose escalated simultaneous integrated boost of gross nodal disease in gynecologic cancers: a multi-institutional retrospective analysis and review of the literature

“…Other studies have also identified improved nodal control or OS with increasing dose. The reported LN size thresholds for benefit have ranged from ≥1.5 to 2.4 cm [ 1 , 14 , 19 - 23 ]. The number of positive nodes, LN SUV (standardized uptake value) heterogeneity, maximum LN SUV, and various other factors have demonstrated prognostic value [ 4 , 18 , 24 - 27 ].…”