Posttherapy Surveillance of Women with Cervical Cancer: An Outcomes Analysis

Bodurka, Diane C.; Morris, Mitchell; Eifel, Patricia J.; Levenback, Charles; Bevers, Michael W.; Lucas, Kristin R.; Jt, Wharton

doi:10.1006/gyno.2000.5860

Cited by 169 publications

(102 citation statements)

References 7 publications

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“…We also found that patients without symptoms showed a better SAR rate compared to those with symptoms (p = 0.012), which also matches the observations of earlier studies [6,7,8]. According to these data, we can infer that postoperative follow-up programs could positively affect the prognosis of these patients.…”

Section: Discussionsupporting

confidence: 80%

“…They also suggested a Pap smear once a year until the 5th year, and a chest X-ray once a year during the 1st and 5th year and twice a year from the 2nd to the 4th year. Not all physicians agree that a Pap smear is useful for the detection of recurrent cervical cancer [7,10,11,24]. Although a Pap smear has high specificity, the sensitivity is poor [10,11,12,22].…”

Section: Discussionmentioning

confidence: 99%

“…According to these data, we can infer that postoperative follow-up programs could positively affect the prognosis of these patients. However, the type of surveillance procedure used as part of routine follow-up has been the subject of ongoing debate among physicians, and to date, the evidence base to support any side of the debate has been limited [2,7,21,22,23,24]. Recently, a Cochrane review of follow-up protocols for cervical cancer patients after primary treatment found much diversity in protocols but an absence of evidence-based methods for detecting recurrence [25].…”

Section: Discussionmentioning

confidence: 99%

“…Bodurka-Bevers et al [7 ]studied the impact of a post-therapy surveillance program on 133 patients with cervical cancer stage IB. They suggested that routine follow-ups should focus on pelvic examination and chest X-ray, rather than on a Pap smear.…”

Section: Discussionmentioning

confidence: 99%

“…The second aim is based on the assumption that earlier detection of recurrent disease will result in salvage treatment and increased survival [2]. Several studies have documented that cervical cancer patients with asymptomatic recurrence showed significantly longer survival than those with symptomatic recurrence [6,7,8,9,10], which may indicate the benefit of routine follow-up procedures. However, other studies have found no benefit from routine follow-up procedures in improving the survival of patients treated for cervical cancer [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Aspects and Prognostic Factors for Survival in Patients with Recurrent Cervical Cancer after Radical Hysterectomy

Hanprasertpong

Jiamset²,

Geater³

et al. 2016

Oncol Res Treat

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Background: The aim of this study was to investigate the clinical aspects and prognostic factors for survival in patients with recurrent cervical cancer after radical hysterectomy with node dissection (RHND) for stages IA2-IB1. Patients and Methods: Clinicopathologic characteristics of the primary tumor, pattern of recurrence, method of detection, salvage treatment, and outcome were reviewed from the medical records of patients who underwent RHND between 1987 and 2015. Prognostic factors were identified using a Cox regression model. Results: Of 702 patients enrolled in the study, 84 (11.9%) had recurrence. 58, 17, and 9 patients had locoregional, distant, and combined recurrence, respectively. No association between clinicopathologic features and recurrence patterns was observed. Most recurrence patients (63.1%) complained of symptoms prior to examination. The majority of asymptomatic recurrence patients (71.4%) were diagnosed by physical and/or pelvic examination. 5-year overall survival after recurrence (SAR) was 34.3%. On multivariate analysis, pattern of recurrence (p = 0.003), symptom status (p = 0.011), age (p = 0.035), and white blood cell (WBC) count (p = 0.017) were independent prognostic factors for overall SAR. Conclusion: Only pattern of recurrence, symptom status, age, and WBC count were found to be prognostic factors in recurrent cervical cancer after RHND. Follow-up programs after RHND should be directed toward early detection of recurrence.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Clinical Aspects and Prognostic Factors for Survival in Patients with Recurrent Cervical Cancer after Radical Hysterectomy

Hanprasertpong

Jiamset²,

Geater³

et al. 2016

Oncol Res Treat

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Association of Posttherapy Positron Emission Tomography With Tumor Response and Survival in Cervical Carcinoma

Schwarz¹,

Siegel²,

Dehdashti³

et al. 2007

JAMA

272

159

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ContextRetrospective studies have demonstrated that the use of positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG) in the posttherapy evaluation of patients with cervical carcinoma is predictive of survival outcome.Objective To validate the association between the metabolic response on the 3-month posttherapy FDG-PET and long-term survival outcome. Design, Setting, and PatientsA prospective cohort study designed to validate our previous finding that the results of a 3-month posttherapy FDG-PET are predictive of long-term clinical outcome. A total of 92 women were treated with external irradiation, brachytherapy, and concurrent chemotherapy from January 2003 through September 2006. Posttherapy whole-body FDG-PET was performed 2 to 4 months (mean, 3 months) after completion of therapy. Main Outcome MeasuresThe primary outcome end points were metabolic response, progression-free survival, and cause-specific survival.Results Posttherapy FDG-PET showed a complete metabolic response in 65 patients (70%), a partial metabolic response in 15 (16%), and progressive disease in 12 (13%). Their 3-year progression-free survival rates were 78%, 33%, and 0%, respectively (PϽ.001). Multivariate analysis demonstrated that the hazard ratio (HR) for risk of recurrence based on the posttherapy metabolic response showing progressive disease was 32.57 (95% confidence interval [CI],. A partial metabolic response had an HR of 6.30 (95% CI, 2.73-14.56). These were more predictive of survival outcome than the pretreatment lymph node status (HR, 3.54; 95% CI, 1.54-8.09). ConclusionIn this single-site study population of women with cervical cancer, 3-month posttherapy FDG uptake, as detected by whole-body PET, was predictive of survival.

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