Identification of High-Risk Groups among Node-Positive Patients with Stage IB and IIA Cervical Carcinoma

Samlal, Rahul A. K.; Velden, J. van der; Schilthuis, Marten S.; González, D. González; Kate, Fiebo J. ten; Hart, A. A. M.; Lammes, F. B.

doi:10.1006/gyno.1996.4576

Cited by 56 publications

(42 citation statements)

References 29 publications

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“…Previous literature showed that increased angiogenic activity correlated well with prognosis and overall survival in cervical cancer (Cheng et al 2000;Kaku et al 1998;Obermair et al 1998;Wiggins et al 1995). Another noticeable result is that in our study serum VEGF levels were not signiWcantly diVerent between patients with squamous cell carcinoma and those with adeno-or adenosquamous carcinoma, whereas others found adenocarcinoma to be the more angiogenic (Fujimoto et al 1999) and aggressive subtype (Samlal et al 1997).…”

Section: Discussionsupporting

confidence: 55%

Serum vascular endothelial growth factor: a prognostic factor in cervical cancer

Zusterzeel

Span

Dijksterhuis

et al. 2008

J Cancer Res Clin Oncol

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Purpose To study pre-treatment serum VEGF of patients with invasive cervical cancer and its possible role as prognostic indicator. Methods VEGF was measured using ELISA in the largest patient group (n = 167) to date. Reults Serum VEGF was signiWcantly higher in advanced tumor stage (P = 0.01), large tumor size (tumors larger than 2 cm) (P = 0.03), and the presence of vascular space invasion (P = 0.05). Serum VEGF was associated with disease free and overall survival [DFS: Hazard Ratio (HR) = 2.61; 95% CI 1.32-5.17; P = 0.006; for OS: HR = 2.09; 95% CI 1.54-2.84; P < 0.001, respectively]. In multivariate Cox regression serum VEGF retained its prognostic value for DFS (HR = 2.10, P = 0.03) and OS (HR = 1.92, P = 0.04). Conclusions Serum VEGF levels correlate with more advanced and more aggressive disease in cervical cancer and may be a useful prognostic factor in patients with cervical cancer.

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Section: Discussionsupporting

confidence: 55%

Serum vascular endothelial growth factor: a prognostic factor in cervical cancer

Zusterzeel

Span

Dijksterhuis

et al. 2008

J Cancer Res Clin Oncol

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“…These are patients with multiple nodal metastases and/or extrapelvic node metastasis who are considered high-risk node-positive patients. In addition to nodal status, adenocarcinoma, 62,65,66 parametrial infi ltration, 62,63,65 and S-phase fraction and elevated SCC level 87 are associated with poorer survival in patients with nodepositive cervical cancer. Several reports have shown predictors for the survival of patients with lymph node metastasis determined by multivariate analysis (Table 6).…”

Section: Treatment Of Node-positive Cervical Cancermentioning

confidence: 98%

“…Independent prognostic factors in node-positive patients patients Lai et al (1993) 9 105 Parametrial infi ltration, number of positive lymph nodes, DNA index Stock et al (1995) 64 143 Pelvic radiotherapy a , number of positive lymph nodes, LVSI Samlal et al (1997) 65 68 Adenocarcinoma, parametrial infi ltration Aoki et al (2000) 63 59…”

Section: Number Ofmentioning

confidence: 99%

“…Several reports have shown predictors for the survival of patients with lymph node metastasis determined by multivariate analysis (Table 6). 9,[63][64][65] The Gynecologic Oncology Group/Southwest Oncology Group/Radiation Therapy Oncology Group (GOG 109/ SWOG 8797/RTOG 91-12) clinical trial evaluated patients with positive pelvic lymph nodes and/or microscopic involvement of the parametrium and/or positive surgical margins, who were randomly allocated to receive either pelvic radiotherapy alone or radiotherapy in combination with chemotherapy (cisplatin + 5-fl uorouracil ). 88 The results demonstrated that progression-free and overall survivals were signifi cantly improved with the addition of chemotherapy.…”

Section: Treatment Of Node-positive Cervical Cancermentioning

confidence: 99%

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Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer

Sakuragi

2007

Int J Clin Oncol

121

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Lymph node metastasis (LNM), together with parametrial infiltration and positive surgical margins, is an important prognostic factor in cervical cancer. The incidence of LNM increases with International Federation of Gynecology and Obstetrics (FIGO) stage, with rates being 12%-22% in stage Ib, 10%-27% in stage IIa, and 34%-43% in stage IIb. Radical hysterectomy and pelvic lymphadenectomy are widely used treatments for early-stage (Ib to IIa) cervical cancer, as well as for stage IIb disease, in some European and Asian countries. In several types of cancer, the therapeutic significance of systematic lymphadenectomy has been demonstrated by recent reports showing that a larger number of lymph nodes removed relates to better survival. In cervical cancer, a significant relationship between the number of lymph nodes removed and disease-free survival has been reported in node-positive patients. Preoperative evaluation of nodal status with computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) imaging techniques is not sensitive enough to replace the histological examination of dissected nodes. The sentinel node procedure may be an alternative to systematic lymphadenectomy to reduce treatment-related morbidity, but more work on this is needed. Although the presence of LNM does not change FIGO staging, it will modulate postoperative therapy. Progression-free and overall survivals were significantly improved by the addition of chemotherapy to adjuvant radiotherapy after radical hysterectomy and lymphadenectomy. Adjuvant chemotherapy combined solely with radical hysterectomy and systematic lymphadenectomy may also provide a survival benefit. In conclusion, efforts to establish more tailored surgical strategies, by introducing advanced imaging technologies and molecular diagnostic procedures, are needed for cervical cancer.

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“…A positive surgical margin is widely recognized as a significant risk factor for the recurrence of cervical cancer [61,62] . In the present study, the existence of cancer tissue within the area of surgical incision was confirmed in only 13 patients (12.7%), comparable to previously reported results [40,43] .…”

Section: Discussionmentioning

confidence: 99%

Prognostic Parameters for Patients with Cervical Cancer FIGO Stages IA2-IIB: A Long-Term Follow-Up

Obrzut¹,

Semczuk

Naróg

et al. 2017

Oncology

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Objective: We assessed the prognostic factors related to 10-year overall survival and disease-free survival in cervical cancer patients that underwent primary surgical protocols in 1 institution. Materials and Methods: A total of 102 patients with uterine cervical cancer at FIGO stages IA2-IIB that underwent a Piver type III radical hysterectomy and pelvic lymphadenectomy between 1998 and 2001 were included. Univariate and multivariate analyses of 10-year overall survival and 10-year disease-free survival were performed. Results: Univariate analysis revealed that only lymphovascular space invasion significantly affected 10-year overall survival (p = 0.04), but it had no effect on the 10-year disease-free survival rate. Multivariate analysis demonstrated that survival rates were significantly affected by FIGO stage (p = 0.02, 95% CI: 1.18-5.55, for 10-year overall survival; p = 0.03, 95% CI: 1.07-6.12, for 10-year disease-free survival) and metastases to the pelvic lymph nodes (p = 0.0005, 95% CI: 1.81-8.53, for 10-year overall survival; p = 0.01, 95% CI: 1.26-7.24, for 10-year disease-free survival). Conclusions: The only independent prognostic factors for 10-year survival rates in patients with cervical cancer at FIGO stages IA2-IIB were clinical stage and presence of metastases to the pelvic lymph nodes. The presence of lymphovascular space invasion adversely affected 10-year overall survival.

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Identification of High-Risk Groups among Node-Positive Patients with Stage IB and IIA Cervical Carcinoma

Cited by 56 publications

References 29 publications

Serum vascular endothelial growth factor: a prognostic factor in cervical cancer

Serum vascular endothelial growth factor: a prognostic factor in cervical cancer

Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer

Prognostic Parameters for Patients with Cervical Cancer FIGO Stages IA2-IIB: A Long-Term Follow-Up

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