Extended field irradiation for cervical cancer based on surgical staging

Hughes, Rhidian; Brewington, Kenneth C.; Hanjani, Parviz; Photopulos, Guy J.; Dick, Don D.; Votava, Charles; Moran, Mark; Coleman, Sidney A.

doi:10.1016/0090-8258(80)90022-0

Cited by 69 publications

(17 citation statements)

References 3 publications

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“…[1][2][3][4][5] Imaging techniques are unable to reliably identify occult lymphatic spread. Investigation into the role of laparoscopic pelvic lymphadenectomy in the staging of early cervical carcinoma emerged in the late 1980s.…”

mentioning

confidence: 99%

Extraperitoneal endosurgical aortic and common iliac dissection in the staging of bulky or advanced cervical carcinomas

Querleu

Dargent

Ansquer

et al. 2000

Cancer

130

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mentioning

confidence: 99%

Extraperitoneal endosurgical aortic and common iliac dissection in the staging of bulky or advanced cervical carcinomas

Querleu

Dargent

Ansquer

et al. 2000

Cancer

130

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“…Pilleron et al [109] noted a 5-year survival rate of only 16% of patients with positive common iliac nodes in stages I and II. In advanced stages, 5-year survival rates of patients with para-aortic disease ranging from 16 to 32% have been described, illustrating the bleak prognosis [3,11,63,112,115]. Pelvic 70 195 194 108 362 139 418 124 98 363 193 143 293 145 63 73 363 193 98 202 293 98 140 254 171 143 183 51 3 (4) 18 (9) 19 (10) 11 (10) 47 (13) 20 (14) 62 (15) 22 (18) 19 (19) 73 (20) 42 (22) 35 (24) 71 (24) 39 (27) 19 (30) 25 (34) 8 (2) 4 (2) 3 (3) 5 (3) 20 (7) 3 (3) 6 (4) 9 (4) 9 (5) 8 (6) 11 (6) 5 (10) 62 2 61 79 64 16 47 19 30 70 127 76 71 110 89 24 70 127 30 60 71 30 63 99 47 76 11 8 a Figures in parenthesis denote percentages.…”

Section: Lymph Node Metastasesmentioning

confidence: 99%

“…Extended-field radiation has been used more in advanced stages, because in these stages there is a relatively high incidence of para-aortic node involvement, 17-358 [3,11,37,63,76,131,136]. However, there also seems to be a high incidence of para-aortic disease in high-risk patients in early stages [63,75,136]. Early-stage patients with tumors of more than 4 cm, blood vessel invasion, or para-aortic or multiple (> 3) pelvic lymph node metastases appeared to have survival rates which are comparable with those in advaxx.ed stages.…”

Section: The Impact Of Treatmentmentioning

confidence: 99%

A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy

Bommel¹,

Lindert²,

Kock³

et al. 1987

European Journal of Obstetrics & Gynecology and Reproductiv

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Several prognostic factors in stages I B and II A cervical carcinoma have been widely studied to define groups of patients with a poor prognosis. Most of these factors are interrelated. The characteristics which should be regarded as main factors have not yet been defined, because the studies reported were based on mainly retrospective and non-randomized analysis. Reviewing the literature, lymph node metastasis, differentiation grade, tumor size, parametrial extension, lymphblood vessel invasion and cervical invasion seem to be prognostically important factors, which suggests that the subdivision of patients according to the FIG0 classification alone is inaccurate. It seems useful to define subgroups of patients according to tumor characteristics, determined after surgical treatment and accurate histologic examination of the surgical specimen. Patients with one or more of these tumor features need additional treatment to improve survival. The current treatment modalities, such as postoperative radiotherapy, have not been thoroughly evaluated, but doubt exists as to their efficacy. Data in the literature suggest that particularly patients with para-aortic or multiple pelvic lymph node metastasis (> 3) have already developed distant metastases at the time of primary treatment and therefore need adjuvant systemic therapy. Patients with tumors larger than 4 cm in diameter, differentiation grade III, lymph-blood vessel invasion or cervical invasion (of more than 70%) seem to have high recurrence rates at both pelvic and distant sites, indicating that there is also a need for better pelvic control.

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“…According to a previous report, the mean complications rate of surgical PALN staging procedures is 9 % (range: 4-24 %) (Fine et al 1995;Hughes et al 1980). Retrospective studies have suggested that a retroperitoneal approach, laparoscopic surgery, and robotic surgery are all associated with lower rates of postoperative complications compared with an intraperitoneal approach (Smits et al 2014).…”

Section: Surgical Staging Of the Palnmentioning

confidence: 95%