Patterns of treatment failure following radiotherapy with combination chemotherapy for patients with high-risk stage IIB cervical carcinoma

Park, Tchan Kyu; Kwon, Ja Young; Kim, Sang Wun; Kim, Sung Hoon; Kim, Soo Nyung; Kim, Gwi Eon

doi:10.1007/s10147-003-0378-9

Cited by 21 publications

(23 citation statements)

References 22 publications

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“…Park et al 69 reported that, of 349 patients treated with concurrent radiotherapy and chemotherapy, treatment failure occurred in 79 patients (22.6%). Forty-six (13.2%) had persistent disease and 33 (9.5%) had recurrent disease.…”

Section: Pattern Of Failure In Node-positive Cervical Cancermentioning

confidence: 98%

“…Pelvic failure was the most frequent failure in the group with tumors sized 4 cm or more, whereas, for the positivelymph-node group, distant metastasis was most frequent and metastases to paraaortic lymph nodes was common. 69 Aoki et al 70 reported the failure pattern in 161 patients with lymph-node negative stage Ib-II cervical cancer treated with radical hysterectomy and postoperative radiotherapy. For this group of patients, deep cervical stromal invasion was the only independent prognostic factor, and the rate of recurrence in pelvic and distant sites was almost equal.…”

Section: Pattern Of Failure In Node-positive Cervical Cancermentioning

confidence: 98%

“…If the positive node is limited to one node or one nodal group, it has virtually no adverse effects on patient survival. 9,12,29,37,69 Inoue and Morita 29 reported the effect of the number of positive nodes on stage Ib to IIb cervical cancer. The 5-year survival rate for node-negative patients, patients with, one positive node, those with two to three positive nodes, and those with four or more positive nodes was 89%, 81%, 41%, and 23%, respectively.…”

Section: Pattern Of Spread Of Lymph Node Metastasismentioning

confidence: 98%

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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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Section: Pattern Of Failure In Node-positive Cervical Cancermentioning

confidence: 98%

Section: Pattern Of Failure In Node-positive Cervical Cancermentioning

confidence: 98%

Section: Pattern Of Spread Of Lymph Node Metastasismentioning

confidence: 98%

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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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“…In an analysis of the pattern of failure, Park et al [24] could demonstrate the correlation between lymph node recurrence and distant metastases in patients with stage IIB cervical cancer: 19% of the patients had pelvic nodal failure after chemoradiation. 11.6% of the patients with pelvic failure developed distant metastases compared to 6.5% of the patients with locally controlled tumors.…”

Section: Discussionmentioning

confidence: 99%

Interindividual Variability of Lymph Drainages in Patients with Cervical Cancer

et al. 2006

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Common iliac lymph node metastases are found in up to 50% of patients with node-positive cervical cancer. The results of this study demonstrate an unsatisfactory coverage of the common iliac lymph drain by standard fields in most patients. Thus it is necessary to individualize the planning target volume and to include the whole common iliac vessels according to the patient's anatomy on radiation treatment planning CT in order to improve local control.

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“…In cases where there is only 1 positive node, no adverse effect on patient survival has been observed, according to certain authors (16,17). Inoue and Morita (14) reported on the effect of the number of positive LNs on stage IB-IIB cervical cancer.…”

Section: Progression-free Survivalmentioning

confidence: 96%

Prognostic significance of positive lymph node number in early cervical cancer

Park

Bae

2016

Molecular and Clinical Oncology

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Abstract. The aim of the present study was to investigate whether the number of metastatic lymph nodes (LNs) is an independent prognostic factor for early cervical cancer. The medical records of 163 stage IB-IIA cervical cancer patients, treated with radical hysterectomy with accompanying pelvic and/or para-aortic lymphadenectomy between 1999 and 2007, were retrospectively reviewed. All prognostic factors identified as being significant in the univariate analysis were included in the multivariate analysis using the Cox proportional hazards model. Of the 156 patients included in our analysis, 27 had LN metastasis, of whom 14 patients had 1 positive node and 13 patients had ≥2 positive nodes. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 92.9 and 87.2%, respectively. In terms of OS, tumour stage (P=0.002) and the number of positive LNs (P=0.021) were identified as significant prognostic factors. In terms of PFS, tumour stage (P= 0.049) was identified as a significant prognostic factor. In conclusion, the number of LN metastases is an independent risk factor for poorer survival outcomes in patients with cervical cancer.

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Patterns of treatment failure following radiotherapy with combination chemotherapy for patients with high-risk stage IIB cervical carcinoma

Cited by 21 publications

References 22 publications

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

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

Interindividual Variability of Lymph Drainages in Patients with Cervical Cancer

Prognostic significance of positive lymph node number in early cervical cancer

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