Prognosis and clinicopathological characteristics of Ib-IIb adenocarcinoma of the uterine cervix in patients who have had radical hysterectomy

Irie, Takashi; Kigawa, Junzo; Minagawa, Yukihisa; Itamochi, Hiroaki; Sato, Shinya; Akeshima, Ryoji; Terakawa, Naoki

doi:10.1053/ejso.1999.0923

Cited by 93 publications

(74 citation statements)

References 12 publications

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“…Matthews et al (1993) showed that only nodal positivity was the major prognostic factor for survival in 79 patients with clinical stage I disease. Irie et al (2000) also reported the same result in 57 patients with FIGO stage I -IIB disease (Irie et al, 2000). Ishikawa et al (1999) reported that the clinical stage, the presence of nodal metastasis, lymph -vascular space invasion, and tumour size were independent risk factors in 193 patients with FIGO stage I -IV disease, and number of positive nodes and tumour size were independent risk factors in survival and relapse among patients with FIGO stage I disease.…”

Section: Spread Pattern and Failure Sitesmentioning

confidence: 61%

“…Few reported literature have discussed lymph node status of advanced stage, that is, FIGO stage IIB. Irie et al (2000) reported a higher positive rate of lymph node in patients with AC than in those with SCC of FIGO stage II disease (57.1 vs 26.9%). This discrepancy is probably because of the number of patients, the difference in histological subtypes of AC, and/or the difference between clinical and pathological stages.…”

Section: Spread Pattern and Failure Sitesmentioning

confidence: 94%

“…In the reported literature, no differences were found in positive lymph node rates of FIGO stage IB disease, and positive rates were approximately 5 -15% (Look et al, 1996;Irie et al, 2000;Lee et al, 2006). Few reported literature have discussed lymph node status of advanced stage, that is, FIGO stage IIB.…”

Section: Spread Pattern and Failure Sitesmentioning

confidence: 97%

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Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix

et al. 2009

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A retrospective analysis was carried out to identify risk factors for survival and relapse in patients with FIGO stage I -IIB cervical adenocarcinoma (AC), who underwent radical hysterectomy, and to compare outcome and spread pattern with those of squamous cell carcinoma (SCC). One hundred and twenty-three FIGO stage I -IIB patients with AC and 455 patients with SCC, who all underwent primary radical hysterectomy, were reviewed. Among the patients with AC, Cox model identified tumour size (95% CI: 1.35 -30.71) and node metastasis (95% CI: 5.09 -53.44) as independent prognostic factors for survival, and infiltration to vagina (95% CI: 1.15 -5.76) and node metastasis (95% CI: 6.39 -58.87) as independent prognostic factors for relapse. No significant difference was found in survival or relapse between the AC and SCC groups, after adjusting for other clinicopathological characteristics using Cox model. No significant difference was found in the positive rates of lymph nodes or location of initial failure sites between the two groups, but ovarian metastatic rate was significantly higher in patients with pathologic stage IIB AC (P ¼ 0.02). Positive node is a common independent prognostic factor for survival and relapse of patients with AC. FIGO stage I -IIB patients with AC or SCC, who underwent radical hysterectomy, have similar prognosis and spread pattern, but different ovarian metastasis rates. At present, standard treatment options for patients with invasive carcinoma of the uterine cervix are as follows: radical hysterectomy followed by adjuvant radiotherapy or primary radiotherapy with concurrent cisplatin-containing chemotherapy, for the patients with the International Federation of Gynecology and Obstetrics (FIGO) stage IB -IIA disease, with equivalent results; and primary radiotherapy with concurrent chemotherapy for the patients with FIGO stage IIB -IVA disease. These therapeutic strategies have been widely accepted. On the other hand, approximately 85% of the patients with carcinoma of the uterine cervix have squamous lesions, and most of the remaining 10% have adenocarcinoma (AC) lesions (Benedet et al, 2003). To our knowledge, no practice guideline has referred to the treatment option based on the difference of histological types between AC and squamous cell carcinoma (SCC) It is not clear whether these histological types influence outcome or spread pattern, and there is still controversy, as conflicting results have appeared in the literature because of potential limitations of small cohorts of patients with AC. The question whether standard treatment for patients with SCC is also suitable for patients with AC remains unanswered. Additionally, over the last decade, the proportion of AC relative to SCC has doubled, and the rate of AC per population at risk has also increased (Smith et al, 2000). To establish a framework for designing therapeutic strategies, the present retrospective study was undertaken firstly to clarify the clinicopathological features of the surgically treated patients with common typ...

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Section: Spread Pattern and Failure Sitesmentioning

confidence: 61%

Section: Spread Pattern and Failure Sitesmentioning

confidence: 94%

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Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix

et al. 2009

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“…Compared to squamous cell carcinoma, lymph node metastasis is likely to occur early in adenocarcinoma, which has a worse prognosis because it is often unresponsive to therapy (40,41). In the present study, when compared to group O, group Y had a significantly higher incidence of squamous cell carcinoma and early cancer (Table I).…”

Section: Discussionmentioning

confidence: 45%

Vascular endothelial growth factor, matrix metalloproteinases, and cyclooxygenase-2 influence prognosis of uterine cervical cancer in young women

Noriyuki

Sumi²,

Zhi³

et al. 2007

Int J Oncol

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Abstract. Recent changes in the lifestyle of young women have led to an increase in the rate of uterine cervical cancer. We investigated the clinicopathological characteristics of uterine cervical cancer in young women, and examined the expression of vascular endothelial growth factor (VEGF), matrix metalloproteinases (MMPs) and cyclooxygenase-2 (COX-2). Tumor samples from 439 patients with uterine cervical cancer, who were initially treated at

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“…Some authors have reported that cervical adenocarcinoma has a worse prognosis than cervical squamous cell carcinoma (12,(21)(22)(23)(24)(25)(26)(27).…”

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confidence: 99%

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

et al. 2018

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Abstract. Aim: To assess the patterns of recurrence and clinical outcomes of patients with cervical adenocarcinoma who underwent neoadjuvant platinum-based chemotherapy (NACT) followed by radical hysterectomy. Patients andConcurrent cisplatin-based chemotherapy and radiotherapy (CCRT) is the standard-of-care for patients with locally advanced cervical cancer and recent meta-analyses of randomized trials have confirmed that this therapeutic approach significantly improves progression-free survival and overall survival compared to definitive radiotherapy alone (1-5). Neoadjuvant chemotherapy (NACT) followed by radical hysterectomy is an interesting alternative to CCRT for patients with locally advanced cervical cancer, especially for those with stage Ib2-IIb disease (6-16). A meta-analysis of six randomized trials, including 1078 patients with early or locally advanced disease, revealed that NACT followed by radical hysterectomy significantly reduced the risk of progression [hazard ratio (HR)=0.75, 95% confidence Interval (CI)=0. 61-0.93, p=0.008] and the risk of death (HR=0.77, 95% CI=0.62-0.96 p=0.02) compared to primary radical hysterectomy (17). Moreover, a meta-analysis of five 3627 This article is freely accessible online.

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Prognosis and clinicopathological characteristics of Ib-IIb adenocarcinoma of the uterine cervix in patients who have had radical hysterectomy

Cited by 93 publications

References 12 publications

Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix

Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix

Vascular endothelial growth factor, matrix metalloproteinases, and cyclooxygenase-2 influence prognosis of uterine cervical cancer in young women

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

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