Prognostic factors and operative treatment of Stages IB to IIB cervical cancer

Burghardt, E; Pickel, H.; Haas, Josef; Lahousen, M.

doi:10.1016/0002-9378(87)90374-7

Cited by 188 publications

(103 citation statements)

References 12 publications

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“…The first is that parametrial lymph nodes were detected in Ͼ 90% of the patients, which is a higher rate than that reported previously, 12,13 suggesting that these lymph nodes are present in nearly all women. The lymph nodes were observed in the cardinal ligament, in both layers of the cervicovesical ligament, and, albeit less frequently, in the sacrouterine ligament.…”

Section: Discussioncontrasting

confidence: 37%

“…This finding is markedly higher than the 7% to 27% rate of parametrial involvement reported in the literature for Stage IB patients. 5,12,[14][15][16]18,19 These differences may be related to patient selection, surgical technique, and pathologic assessment of the paracervical tissues. With regard to patient selection, the area equivalent to the cervical tumor in Stage IB1 patients in the current study is similar to that reported by Burghardt and Pickel 5 in the same subset of patients, in which parametrial involvement was found in 17% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…The second finding in the current study is that all patients with pelvic lymph node metastases that we observed had evidence of parametrial involvement, a finding that is markedly different from reports in the literature, in which parametrial invasion has been reported to be observed in 40% to 75% of patients with pelvic lymph node metastases. 5,12,[14][15][16] Furthermore, two patients had parametrial metastases without pelvic lymph node involvement, indicating that the parametrium is the first site of extracervical involvement. These findings are consistent with those of Reiffensthul, who described that the lymph from the cervix is drained by three main trunks: the lateral, the anterior, and the posterior.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Early cervical carcinoma

Benedetti‐Panici

Maneschi

D'Andrea

et al. 2000

Cancer

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Section: Discussioncontrasting

confidence: 37%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Early cervical carcinoma

Benedetti‐Panici

Maneschi

D'Andrea

et al. 2000

Cancer

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“…In cervical cancer, stage, tumor size, histological type, presence of lymphovascular invasion and metastasis to the regional LNs at the time of diagnosis are significant prognostic factors (3,4). However, the prognostic value of SIR in cervical cancer remains unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Poor prognostic factors for cervical cancer include stage, tumor size, histology and lymph node (LN) metastasis (3,4). However, these parameters are not sufficient to accurately predict prognosis.…”

Section: Introductionmentioning

confidence: 99%

Pretreatment prognostic nutritional index is a significant predictor of prognosis in patients with cervical cancer treated with concurrent chemoradiotherapy

Haraga

Nakamura

Omichi

et al. 2016

Molecular and Clinical Oncology

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Abstract. This study investigated whether pretreatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and prognostic nutritional index (PNI) are prognostic factors in patients with cervical cancer who undergo concurrent chemoradiotherapy (CCRT) and radiotherapy (RT). A total of 131 patients who underwent CCRT and RT for cervical cancer were retrospectively investigated and the correlations of NLR, PLR and PNI with clinical parameters and prognosis were assessed in CCRT and RT. The CCRT and RT groups had a median progression-free survival (PFS) of 41.82 and 24.72 months, respectively, and an overall survival of 49.70 and 29.56 months, respectively. At a cut-off value of NLR≥2.85, the PFS and OS in patients with higher NLR undergoing RT were significantly shorter compared with those in patients with lower NLR (P=0.029 and P=0.017, respectively). At a cut-off value for PNI of ≤48.55 in patients undergoing CCRT and ≤45.80 in patients undergoing RT, the PFS and OS in patients with lower PNI were significantly shorter compared with those in patients with higher PNI (PFS and OS with CCRT, P<0.001 and P<0.001, respectively; PFS and OS with RT, P=0.002 and P=0.008, respectively). Multivariate analyses also identified low PNI as an independent prognostic factor for PFS and OS in patients receiving CCRT. Therefore, low PNI was shown to predict poor prognosis in patients with cervical cancer.

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Early cervical carcinoma

Benedetti‐Panici

Maneschi

D'Andrea

et al. 2000

Cancer

161

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BACKGROUND Although parametrectomy is the most difficult step in the surgical treatment of cervical carcinoma and is the main cause of postoperative complications, little attention has been given to the patterns of parametrial spread. METHODS Sixty‐nine patients with previously untreated cervical carcinoma (Fédération Internationale de Gynécologie et d'Obstétrique [FIGO] Stage IB1, 49 patients [71%]; Stage IB2, 8 patients [12%]; and Stage IIA, 12 patients [17%]; squamous, 59 patients [86%]; and adenocarcinoma, 10 patients [14%]) underwent radical hysterectomy and pelvic ± aortic lymphadenectomy. Hysterectomy specimens were processed with the giant section technique. To obtain a thorough three‐dimensional assessment of the paracervical tissue, both the superficial and deep layers of the cervicovesical ligament (anterior parametrium) and the uterosacral ligament (posterior parametrium) were separated from the uterus and submitted for pathologic evaluation. After resection of the lateral parametrium with hemoclips, the lympho‐fatty tissue remaining around the pudendal vessels was removed carefully and referred to as “the distal part of the lateral parametrium.” RESULTS When analyzing all the parametria, lymph nodes were present in 64 patients (93%). Clinically undetected parametrial involvement was found by pathologic examination in 15 Stage IB1 patients (31%), 5 Stage IB2 patients (63%), and 7 Stage IIA patients (58%). Metastases were found in the cardinal, cervicovesical, and sacrouterine ligaments and principally were comprised of lymph node and vascular space invasion. Twenty‐five patients (36%) had pelvic lymph node metastases whereas concomitant parametrial involvement was observed in all patients. The overall 5‐year survival was 91%, being higher for parametria and lymph node negative patients (100%) than for those with lymph node and/or parametrial metastases (78%). CONCLUSIONS A three‐dimensional pathologic assessment showed that subclinical parametrial spreading of the so‐called “early” tumors (Stage IB‐IIA) occurred in approximately 30–60% of these patients, and metastasis to the pelvic lymph nodes always was associated with parametrial disease. A better understanding of the patterns of parametrial diffusion will improve knowledge of the natural history of cervical carcinoma and in the future may influence the treatment of these patients. Furthermore, pathologic assessment of cervical carcinoma should be modified to evaluate correctly the parametrial status of each patient. The current routine pathologic evaluation of the parametria makes it very difficult to detect lymph node metastases and tumor emboli. Cancer 2000;88:2267–74. © 2000 American Cancer Society.

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Prognostic factors and operative treatment of Stages IB to IIB cervical cancer

Cited by 188 publications

References 12 publications

Early cervical carcinoma

Early cervical carcinoma

Pretreatment prognostic nutritional index is a significant predictor of prognosis in patients with cervical cancer treated with concurrent chemoradiotherapy

Early cervical carcinoma

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