Neoadjuvant Platinum-based Chemotherapy Followed by Radical Hysterectomy for Stage Ib2-IIb Adenocarcinoma of the Uterine Cervix – An Italian Multicenter Retrospective Study

Gadducci, Angiolo; Landoni, Fabio; Cosio, Stefania; Zizioli, Valentina; Zola, Paolo; Ferrero, Annamaria; Lapresa, Maria Teresa; Maggino, T; Sartori, Enrico

doi:10.21873/anticanres.12637

Cited by 12 publications

(10 citation statements)

References 35 publications

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“…Sixteen studies were included in the systematic review [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and 12 studies in the meta-analysis [15][16][17][18][19][20][23][24][25][27][28][29][30]. Fifty-one studies assessed for eligibility were excluded after applying our exclusion criteria, i.e., the same cohort as a study already included across multiple papers (n = 1), <2 events (N = 4), <10 cases (n = 2), evaluation of clinical rather than pathological response (n = 27), HR with 95% CI not extractable (n = 15), review (n = 2).…”

Section: Study Selectionmentioning

confidence: 99%

“…Eight studies (50%) dichotomized pathological response as "optimal" (complete response or residual with <3 mm stromal invasion) vs. "suboptimal" (residual with >3 mm stromal invasion) [17,19,21,[23][24][25][26]29]; two studies (12.50%) assessed the proportion of viable cells (<1/3, 1/3-to-2/3 or >2/3) [15,20]; two studies (12.50%) assessed the diameter of the residual tumor (cut-offs at 1 mm or 5 mm) [16,18]; two studies (12.50%) dichotomized pathological response as complete disappearance of the tumor vs. any residual [23,30]; one study (6.25%) dichotomized the residual tumor as intracervical vs. extracervical [27]; the remaining study (6.25%) adopted several systems simultaneously, proposing a combined score [22]. Seven studies (43.75%) assessed OS [15][16][17][18][19][20]30], one (6.25%) assessed PFS [24], and eight (50%) assessed both OS and PFS [21][22][23][24][25][26][27][28][29]. Characteristics of the included studies are reported in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Depth of Stromal Invasion as the Most Prognostically Relevant Regression System in Locally Advanced Cervical Cancer after Neoadjuvant Treatment: A Systematic Review and Meta-Analysis Grading

et al. 2021

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Background: several different criteria have been proposed to categorize the pathological response in cervical cancer after neoadjuvant therapy; although it is unclear what the most prognostically valuable one is. Objective: to assess the prognostic value of pathological criteria for categorizing the response in cervical cancer after neoadjuvant therapy, through a systematic review and meta-analysis. Methods: four electronic databases were searched from January to December 2020 for all studies, assessing the prognostic value of pathological response in cervical cancer after neoadjuvant therapy. Hazard ratio (HR) for overall survival (OS) was calculated with a significant p-value < 0.05. A meta-analysis was performed for each criteria assessed in at least three studies. Results: sixteen studies were included. Criteria for pathological response included (i) residual stromal invasion < vs. >3 mm; (ii) complete response vs. any residual; (iii) proportion of viable cells; (iv) residual tumor diameter; and (v) intracervical vs. extracervical residual. Criteria (i) and (ii) were suitable for meta-analysis. The presence of a residual tumor with stromal invasion > 3 mm showed a HR of 4.604 (95% CI; 3.229–6.565; p < 0.001), while the presence of any residual showed a HR of 1.610 (95% CI; 1.245–2.081; p < 0.001); statistical heterogeneity was absent in both analyses. Conclusions: dichotomizing the pathological response in cervical cancer after neoadjuvant therapy as < vs. >3 mm stromal invasion is more prognostically valuable than dichotomizing as complete response vs. any residual. Further studies are necessary to evaluate other systems.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Depth of Stromal Invasion as the Most Prognostically Relevant Regression System in Locally Advanced Cervical Cancer after Neoadjuvant Treatment: A Systematic Review and Meta-Analysis Grading

et al. 2021

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“…Compared with RS alone, especially compared with CCRT, NACT + RS may improve the long-term disease-free survival rate and overall survival rate of patients with locally advanced cervical cancer stage IB2-IIB [ 7 ]. Moreover, total hysterectomy after NACT may be an option for patients with stage Ib2-IIb cervical adenocarcinoma [ 46 ]. However, this study found that NACT did not improve overall survival, but reduced the number of patients receiving postoperative radiotherapy [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness comparisons of various therapies for FIGO stage IB2/IIA2 cervical cancer: a Bayesian network meta-analysis

et al. 2021

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Background Cervical cancer is a common malignancy of the female genital tract. Treatment options for cervical cancer patients diagnosed at FIGO (2009) stage IB2 and IIA2 remains controversial. Methods We perform a Bayesian network meta-analysis to directly or indirectly compare various interventions for FIGO (2009) IB2 and IIA2 disease, in order to improve our understand of the optimal treatment strategy for these women. Three databases were searched for articles published between 1971 and 2020. Data on included study characteristics, outcomes, and risk of bias were abstracted by two reviewers. Results Seven thousand four hundred eighty-six articles were identified. Thirteen randomized controlled trials of FIGO (2009) IB2 and IIA2 cervical cancer patients were included in the final analysis. These trials used six different interventions: concomitant chemoradiotherapy (CCRT), radical surgery (RS), radical surgery following chemoradiotherapy (CCRT+RS), neoadjuvant chemotherapy followed by radical surgery (NACT+RS), adjuvant radiotherapy followed by Radical surgery (RT + RS), radiotherapy alone (RT).SUCRA ranking of OS and Relapse identified CCRT+RS and CCRT as the best interventions, respectively. Systematic clustering analysis identified the CCRT group as a unique cluster. Conclusion These data suggest that CCRT may be the best approach for improving the clinical outcome of cervical cancer patients diagnosed at FIGO (2009) stage IB2/IIA2. Phase III randomized trials should be performed in order to robustly assess the relative efficacy of available treatment strategies in this disease context.

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“…Detailed information on OCTA imaging is available elsewhere. 19,23,24 The optical microangiographycomplex algorithm analyzed the changes in complex signals (both phase and intensity changes contained within sequential B-scans obtained at the same position), and then generated en face microvascular images of the SVC, which spanned from the inner limiting membrane to the posterior surface of the inner-plexiform layer. The AngioPlex incorporates the FastTrac retinal tracking technology to minimize motion artifacts.…”

Section: Octa Imagingmentioning

confidence: 99%

Effects of Beta-zone Peripapillary Atrophy and Focal Lamina Cribrosa Defects on Peripapillary Vessel Parameters in Young Myopic Eyes

Choe

Kim

Lim

et al. 2021

Journal of Glaucoma

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Precis: The development of beta-zone peripapillary atrophy (β-PPA) and focal lamina cribrosa defect (FLD) was significantly associated with decreased peripapillary optical coherence tomography angiography (OCTA) vessel parameters in young myopic eyes. Purpose: The purpose of this study was to investigate whether β-PPA and FLD affect peripapillary vessel density (VD) or perfusion density (PD) from OCTA in young myopic eyes. Materials and Methods: In a cross-sectional study, 330 eyes of 165 healthy volunteers with myopia were involved. Eyes underwent OCTA to measure peripapillary PD and VD. Eyes were grouped according to the presence of β-PPA or FLD: eyes without β-PPA or FLD (group A), eyes with β-PPA but without FLD (group B), and eyes with both β-PPA and FLD (group C). PD and VD were compared among 3 groups, and linear mixed-effect regression model was used to investigate the determinants of PD. Results: β-PPA was found in 219 eyes (66.4%), and FLD was detected in 27 eyes (8.2%). The average VD and PD were greatest in group A (19.13±2.04 mm–1 and 0.375±0.038), followed by group B (18.34±2.26 mm–1 and 0.363±0.042) and group C (16.71±2.81 mm–1 and 0.330±0.052) (P<0.001). The linear mixed-effect model demonstrated that presence of FLD (P=0.001) or β-PPA (P<0.001), FLD count (P=0.004), and maximal β-PPA width (P<0.001) were significantly associated with average PD after controlling for multiple confounding factors. Conclusions: Development of β-PPA and FLD, which is closely related with axial elongation in myopic eyes, was significantly associated with reduced OCTA vessel parameters in young myopic eyes. OCTA may help to detect vascular changes and assess glaucoma risk in these eyes.

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Neoadjuvant Platinum-based Chemotherapy Followed by Radical Hysterectomy for Stage Ib2-IIb Adenocarcinoma of the Uterine Cervix – An Italian Multicenter Retrospective Study

Cited by 12 publications

References 35 publications

Depth of Stromal Invasion as the Most Prognostically Relevant Regression System in Locally Advanced Cervical Cancer after Neoadjuvant Treatment: A Systematic Review and Meta-Analysis Grading

Depth of Stromal Invasion as the Most Prognostically Relevant Regression System in Locally Advanced Cervical Cancer after Neoadjuvant Treatment: A Systematic Review and Meta-Analysis Grading

Effectiveness comparisons of various therapies for FIGO stage IB2/IIA2 cervical cancer: a Bayesian network meta-analysis

Effects of Beta-zone Peripapillary Atrophy and Focal Lamina Cribrosa Defects on Peripapillary Vessel Parameters in Young Myopic Eyes

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