Postoperative Adjuvant Chemotherapy for Node-Positive Cervical Adenocarcinoma

Abstract

We examined the effectiveness of postoperative adjuvant chemotherapy for node-positive cervical adenocarcinoma. During the period from 1994 to 2002, 98 consecutive patients with clinical stage I and II cervical adenocarcinoma were treated surgically without having undergone any prior treatment. Surgical procedures included radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. Postoperatively, 21 patients were found to have lymph node metastasis, and all were treated with chemotherapy in the absence of radiotherapy. All patients were followed up for at least 5 years. Recurrence developed in 9 of the 21 patients, all 9 died of the disease. Six of the 9 recurrences were extrapelvic lesions. Five-year disease-free survival and overall survival were 57% and 67%, respectively. Recurrence was more common in patients with 6 or more positive nodes than in those with fewer than 3 positive nodes. These data suggest the potential role of postoperative chemotherapy for treatments of cervical adenocarcinoma. However, the effectiveness of chemotherapy alone in node-positive cervical adenocarcinoma was likely not as high as that in squamous cell carcinoma. Despite our use of postoperative chemotherapy in the absence of pelvic radiation, the disease recurred predominantly at distant sites.

Impact of various treatment modalities on the outcome of stage IB1–IIA cervical adenocarcinoma

“…Other therapeutic strategies must be determined for those who need postoperative treatment or other primary treatment options. Takeshima et al [21] reported a study of more than 20 node-positive patients with cervical adenocarcinoma who were treated postoperatively with chemotherapy. The survival data showed that the effectiveness of postoperative chemotherapy was equal to or better than that of RT in node-positive patients with cervical adenocarcinoma.…”

Histopathological features of endometrial cancer. A cross sectional study

“…According to our data, the probability of mortality in early-stage disease recurrent endometrial cancer being a common factor among patients with mortality. This study also identified higher age and advanced stages as contributing factors [11]. Another report by Lortet-Tieulent and colleagues, examining endometrial cancer prevalence in the United States and Europe, discussed higher mortality rates among older patients and those with comorbidities such as diabetes and cardiac diseases [12].…”

Adjuvant chemotherapy for early-stage cervical cancer

“…Other retrospective studies also reported that adjuvant chemotherapy (CDDP based combination regimens) alone showed favorable prognosis without severe complications ( 21 , 29 , 30 , 31 ). Although some previous studies showed that the survival benefits of adjuvant chemotherapy alone for high-risk patients with LNM and/or PI were similar to those of adjuvant RT, CCRT is considered the best treatment of node-positive cervical cancer, especially for adenocarcinomas, at present ( 32 ).…”