Histological criteria for the prognosis in patients with operated squamous cell carcinoma of the cervix

Baltzer, J.; Lohe, K. J.; Köpcke, Wolfgang; Zander, J.

doi:10.1016/0090-8258(82)90026-9

Cited by 54 publications

(19 citation statements)

References 25 publications

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“…Positive correlations with incidence of lymph node metastases and recurrences have been reported in the literature [5,16,25,30,44,94,95]. There is also a vast range in 5-year survival rates of patients with lymph-blood vessel invasion (Table VII).…”

Section: Lymph and Blood Vessel Invasionmentioning

confidence: 63%

“…Several authors reported a significantly better 5-year survival rate with well-differentiated lesions (grade I) in comparison with poorly differentiated tumors (grade III) (Table IV). In addition, a positive correlation with stage and rate of lymph node metastases and recurrences has been described [1,5,8,47,133]. Chung et al [31] noted in their retrospective analysis a significantly higher incidence of lymph node metastases and tumor recurrences in patients with poorly differentiated tumors (grade III) than in those with well or moderately (16) 3 (16) 6 (14) 13 (31) 34 (27) 34 (27) 10 (7) 42 (29) 21 (75) 12 (52) 8 (35) 17 (54) 13 (17) 25 (32) 25 (26) 40 (41 differentiated lesions (grade I-II), namely 53% versus 17% and 20% versus 6%, respectively.…”

Section: Histology: Cell Differentiation and Cell Typementioning

confidence: 99%

“…Most authors measured tumor size by clinical examination at the time of pre-therapeutic staging. Only a few reports gave details on tumor measurement by standardized histological work-up of the removed uterus and parametria [4,5,18,88]. The latter procedure is more accurate, but only possible when surgery is the primary treatment.…”

Section: Tumor Sizementioning

confidence: 99%

“…The latter procedure is more accurate, but only possible when surgery is the primary treatment. Baltzer et al [4,5], for instance, measured the tumor volume of the removed specimen very accurately. In a study of 595 patients they found 17% lymph node metastases when tumor volume was less than 6500 nm and 46% when tumor volume was more than 6500 nm.…”

Section: Tumor Sizementioning

confidence: 99%

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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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Section: Lymph and Blood Vessel Invasionmentioning

confidence: 63%

Section: Histology: Cell Differentiation and Cell Typementioning

confidence: 99%

Section: Tumor Sizementioning

confidence: 99%

Section: Tumor Sizementioning

confidence: 99%

See 2 more Smart Citations

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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“…When clinical staging was compared with surgical staging, inaccuracies (mostly understaging) were found in 10-25% of patients with clinical stage IB or IIA [2][3][4]. Several authors have demonstrated reduced survival in patients with lymph node metastases and lymph or blood vessel invasion [5,6], It seems useful to develop new strategies to define subgroups of patients in order to further individualize treatment.…”

Section: Introductionmentioning

confidence: 99%

Improvement of Clinical Staging in Cervical Cancer with Serum Squamous Cell Carcinoma Antigen and CA 125 Determinations

Massuger¹,

Koper²,

Thomas³

et al. 1997

Gynecologic Oncology

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Staging of cervical cancer is routinely performed by means of examination under anesthesia in combination with radiographic and/or endoscopic techniques. This "clinical" staging leads to 1 0 -25% misclassification, mostly due to positive lymph nodes or lymph or blood vessel invasion. Determination of pretreatment squamous cell carcinoma antigen (SCC) and CA 125 serum levels may so lv e part of this staging problem and may improve the selec tion o f the most appropriate individual therapy. Using 2.5 ng/ml (SCC) and 35 U/ml (CA 125) as cutoff levels, we studied 99 pa riente retrospectively. Elevated levels were found in 27% (SCC) and 23% (CA 125). In clinical stage IB or IIA disease 45/81 patients had positive nodes or lymph or blood vessel invasion at operation. Of th ese patients 49% had elevated serum levels of SCC or CA 125. Strongest correlation was found with blood vessel invasion (57%). Only 19% of low-stage patients without evidence of vascular spread o f disease had positive levels. The positive predictive value of SC C and CA 125 for detection of vascular spread of disease in low-stage cervical cancer was 76%. In most centers surgery is the primary treatment of choice in low-stage cervical cancer. Never theless, with respect to patient survival, results of primary surgery and primary radiotherapy are comparable. Radiotherapy given in an adjuvant setting leads to a high incidence of severe complica tions. In order to overcome part of these complications one should consider radiotherapy as the primary therapy of choice in patients with clinical stage IB or IIA cervical cancer with elevated pretreat ment SCC or CA 125 levels.

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Biology of cervical carcinoma

Nguyen¹,

Averette

1999

Semin. Surg. Oncol.

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Cervical cancer is generally a locoregional disease. The endopelvic fascia envelops the cervix in anterior‐posterior fashion and serves as a natural barrier. Thus, cervical cancer preferentially grows to the parametria and involves the ureters before it infiltrates the bladder or rectum. Disease stage, grade, cell type, tumor volume, depth of stromal invasion, vascular space invasion, and lymph node status are common prognostic indicators. Irregular vaginal bleeding and discharge are the two most frequent complaints. Although cervical cancer is still staged clinically, data continue to accumulate favoring a conversion to surgical staging to improve accuracy and treatment outcome. Semin. Surg. Oncol. 16:212–216, 1999. © 1999 Wiley‐Liss, Inc.

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Histological criteria for the prognosis in patients with operated squamous cell carcinoma of the cervix

Cited by 54 publications

References 25 publications

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

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

Improvement of Clinical Staging in Cervical Cancer with Serum Squamous Cell Carcinoma Antigen and CA 125 Determinations

Biology of cervical carcinoma

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