Prognostic factors in FIGO stage IB cervical cancer without lymph node metastasis and the role of adjuvant radiotherapy after radical hysterectomy

Ayhan, Ayşe; Al, Rhyne; Baykal, Cem; Demirtaş, Eren; Yüce, K.

doi:10.1111/j.1048-891x.2004.014212.x

Cited by 44 publications

(26 citation statements)

References 32 publications

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“…Considering the high incidence of lymph-vascular space invasion in our study, 9 more patients (32.1%) would have received adjuvant radiation according to the results reported by GOG 92. However, our study period was before the availability of the result of GOG 92, and skipping adjuvant radiation despite the recommendations of GOG 92 has also been supported in other previous reports [13][14][15] . The results of many contradicting reports regarding adjuvant treatment in patients with intermediate risk factors mandate the importance of counseling patients about the likelihood of requiring adjuvant therapy and its efficacy.…”

Section: Discussionsupporting

confidence: 77%

Treatment Patterns and Outcomes in Bulky Stage IB2 Cervical Cancer Patients: A Single Institution’s Experience over 14 Years

Kim¹,

Chang²,

Chang³

et al. 2010

Gynecol Obstet Invest

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Aim: The aim of this study was to assess various treatment options in stage IB2 cervical cancer patients. Methods: Between January 1995 and May 2007, 63 patients with stage IB2 were treated by radical hysterectomy (n = 28), primary concurrent chemoradiation (CCRT, n = 16) or radiation therapy (RT, n = 19). Disease-free survival (DFS) and overall survival (OS) were compared between these treatment modalities. Results: The 3-year DFS of the surgical approach group was 67.5% compared to 70.3% of the primary RT/CCRT group (p = 0.603). The 5-year OS of all patients was 75.9%. The 5-year OS of the surgical approach group was 81.6% compared to 76.2% of the primary RT/CCRT group (p = 0.578). Twelve (42.8%) of 28 surgically treated patients had high-risk pathologic factors. Out of 20 premenopausal patients who underwent the surgical approach, ovarian preservation was possible in 13 patients without adjuvant CCRT. Of these 13 patients, 7 patients did not experience disease recurrence and continued normal ovarian function. Conclusion: Both radical hysterectomy and primary RT/CCRT are effective treatment options in IB2 cervical cancer. In addition, the surgical approach can be considered for preserving ovarian function in premenopausal IB2 cervical cancer patients.

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Section: Discussionsupporting

confidence: 77%

Treatment Patterns and Outcomes in Bulky Stage IB2 Cervical Cancer Patients: A Single Institution’s Experience over 14 Years

Kim¹,

Chang²,

Chang³

et al. 2010

Gynecol Obstet Invest

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“…These include regional lymph node metastasis, parametrium involvement, positive surgical margin, lymphovascular space involvement, deep stromal invasion, and large tumor size [3,4,5]. However, these pathological factors cannot be used to define the prognosis prior to treatment or for patients who have not received surgery.…”

Section: Introductionmentioning

confidence: 99%

Pretreatment Factors Associated with Recurrence for Patients with Cervical Cancer International Federation of Gynecology and Obstetrics Stage IB1 Disease

Liu

Huang²,

Hu³

et al. 2015

Gynecol Obstet Invest

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Background: Pretreatment prognostic information is lacking for patients with cervical cancer International Federation of Gynecology and Obstetrics (FIGO) stage IB1 disease. Thus, we attempted to identify a high-risk subgroup among them prior to treatment. Methods: Cervical cancer FIGO stage IB1 patients who had received curative treatment with various modalities in our institute between January 2004 and December 2010 were enrolled. Pretreatment clinical parameters including age, squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen, hemoglobin (Hb) level, platelet count, histological type, and treatment modality were analyzed for treatment outcomes. Results: One hundred ninety-seven patients were included with a median follow-up of 66 months (range 6-119 months). In Cox regression analysis, only SCC histology (HR 0.457, 95% CI 0.241-0.967, p = 0.017) was an independent factor predicting better disease-free survival (DFS). Among SCC histology, patients with an Hb level less than 12 g/dl and a SCC-Ag level more than 3 ng/ml had worse treatment outcomes. The 5-year DFS rates were 89.2, 69.3, and 44.4% for the patients at low-risk (SCC, Hb >12 g/dl, SCC-Ag ≤3 ng/ml), intermediate-risk (non-SCC), and high-risk (SCC, Hb ≤12 g/dl, SCC-Ag >3 ng/ml), respectively (p < 0.001). Conclusion: Non-SCC and SCC histology with both anemia and high pretreatment SCC-Ag level were associated with recurrence. Further validation studies are warranted for clarification.

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“…5 Anatomopathological evaluation of the surgical specimen after radical hysterectomy makes it possible to determine prognostic factors that define whether complementary therapy is needed. [6][7][8][9][10][11][12][13][14][15][16] Patients with large tumors in stages Ib and IIa have a greater tendency towards lymph node metastasis and shorter survival, regardless of whether treated by radical hysterectomy or by radiotherapy. 8,9 There is greater incidence of lymph node metastasis in the presence of deep stromal invasion, along with smaller rates of two-year disease-free survival (58% versus 8%), than among patients without stromal invasions and with negative pelvic lymph nodes.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of prognostic factors for cancer of the uterine cervix after radical hysterectomy

et al. 2009

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CONTEXT AND Objective: Cancer of the uterine cervix is still very common in Brazil. It is important to evaluate factors that influence its prognosis. The aim here was to analyze the prevalence of prognostic anatomoclinical factors among patients with carcinoma of the uterine cervix undergoing radical hysterectomy. DESIGN AND SETTING:Cross-sectional study on 301 patients with invasive carcinoma of the uterine cervix who underwent Level III Piver-Rutledge hysterectomy surgery at São Marcos Hospital. METHODS:The following variables were analyzed: age, histological type, degree of differentiation, invasion of lymphatic, vascular and perineural space, lymph node metastasis, distance to nearest margin, tumor invasion depth, vaginal cuff size, largest diameter of the tumor, presence of necrosis and surgical margin involvement. Descriptive statistics, multiple regression analysis, Kaplan-Meier survival curves and the log-rank test were performed. A significance level of 5% was used. RESULTS:The mean age was 48.27 years. The following were not important for the prognosis, in relation to survival analysis: degree of differentiation and tumor invasion depth; presence of lymphatic, blood and perineural invasions; distance to nearest margin; and vaginal cuff size. Tumor size (P < 0.036), presence of lymph node metastasis (P < 0.0004), necrosis (P < 0.05) and surgical margin involvement (P < 0.0015) presented impacts on survival. The overall survival with 98 months of follow-up was 88.35%. CONCLUSION:The most prevalent prognostic factors were the presence of lymph node metastasis, tumor size and surgical margin involvement.RESUMO CONTEXTO E OBJETIVO: O câncer do colo do útero é ainda muito frequente no Brasil, sendo importante avaliar os fatores que influenciam no seu prognóstico. O objetivo é analisar a prevalência dos fatores prognósticos anatomoclínicos em pacientes com carcinoma do colo uterino submetidas a histerectomia radical. TIPO DE ESTUDO E LOCAL:Estudo retrospectivo de 301 pacientes com carcinoma invasivo de colo uterino submetidas a histerectomia radical nível III de Piver-Rutledge no Hospital São Marcos. MÉTODOS:Analisaram-se as variáveis: idade, tipo histológico, grau de diferenciação, invasão do espaço linfático, vascular e perineural, metástase linfonodal, distância da margem mais próxima, profundidade de invasão do tumor, tamanho do manguito vaginal, maior diâmetro do tumor, presença de necrose, comprometimento de margens cirúrgicas. Realizou-se estatística descritiva, análise de regressão múltipla, curva de sobrevida pelo método de Kaplan-Meier e teste log rank. Adotou-se índice de significância de 5%. RESULTADOS:A idade média foi de 48,27 anos. A análise da sobrevida em relação ao grau de diferenciação e profundidade de invasão do tumor, à presença de invasões linfática, sanguínea e perineural, à distância da margem mais próxima e ao tamanho do manguito vaginal não foram importantes no prognóstico. O tamanho do tumor (P < 0,036), presença de metástase linfonodal (P < 0,0004), necrose (P < 0,05) e co...

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Prognostic factors in FIGO stage IB cervical cancer without lymph node metastasis and the role of adjuvant radiotherapy after radical hysterectomy

Abstract: Tumor size, LVSI and vaginal involvement were independent prognostic factors in lymph node negative FIGO stage IB cervical cancer. Adjuvant radiotherapy in stage IB cervical cancer patients with negative nodes provides no survival advantage or better local tumoral control.

Cited by 44 publications

References 32 publications

Treatment Patterns and Outcomes in Bulky Stage IB2 Cervical Cancer Patients: A Single Institution’s Experience over 14 Years

Treatment Patterns and Outcomes in Bulky Stage IB2 Cervical Cancer Patients: A Single Institution’s Experience over 14 Years

Pretreatment Factors Associated with Recurrence for Patients with Cervical Cancer International Federation of Gynecology and Obstetrics Stage IB1 Disease

Prevalence of prognostic factors for cancer of the uterine cervix after radical hysterectomy

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