Small volume stage 1B1 cervical cancer

Biliatis, Ioannis; Kucukmetin, Ali; Patel, Amit; Ratnavelu, Nithya; Cross, Paul; Chattopadhyay, Supratik; Galaal, Khadra; Naik, Raj

doi:10.1016/j.ygyno.2012.03.041

Cited by 60 publications

(11 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Biliatis et al [19] evaluated survival and obstetrical outcomes following conservative management of small-volume stage IB1 cervical cancer. In this series the authors offered an update on the previous publication by Naik et al [12].…”

Section: Data From Studies On Conservative Managementmentioning

confidence: 99%

Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?

Ramírez

Pareja

Rendón

et al. 2014

Gynecologic Oncology

194

126

View full text Add to dashboard Cite

The standard treatment for women with early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. In select patients interested in future fertility, the option of radical trachelectomy with pelvic lymphadenectomy is also considered a viable option. The possibility of less radical surgery may be appropriate not only for patients desiring to preserve fertility but also for all patients with low-risk early-stage cervical cancer. Recently, a number of studies have explored less radical surgical options for early-stage cervical cancer, including simple hysterectomy, simple trachelectomy, and cervical conization with or without sentinel lymph node biopsy and pelvic lymph node dissection. Such options may be available for patients with low-risk early-stage cervical cancer. Criteria that define this low-risk group include: squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma, tumor size <2 cm, stromal invasion <10mm, and no lymph-vascular space invasion. In this report, we provide a review of the existing literature on the conservative management of cervical cancer and describe ongoing multi-institutional trials evaluating the role of conservative surgery in selected patients with early-stage cervical cancer.

show abstract

Section: Data From Studies On Conservative Managementmentioning

confidence: 99%

Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?

Ramírez

Pareja

Rendón

et al. 2014

Gynecologic Oncology

194

126

View full text Add to dashboard Cite

show abstract

“…Some patients with stage IB1 cervical cancer may not need to undergo parametrectomy. It has been reported that less radical surgery including conization, simple trachelectomy, or simple hysterectomy leads to satisfactory oncological outcomes in small-volume stage IB1 cervical cancer [ 19 20 21 ]. Low-risk group criteria for PI have been proposed.…”

Section: Introductionmentioning

confidence: 99%

Pretreatment risk factors for parametrial involvement in FIGO stage IB1 cervical cancer

et al. 2015

View full text Add to dashboard Cite

ObjectiveAll patients with stage IB1 cervical cancer do not need to undergo parametrectomy. Some low-risk criteria for parametrial involvement (PI) have been proposed based on pathological findings. The aim of this study was to determine pretreatment risk factors for PI in stage IB1 cervical cancer.MethodsWe retrospectively reviewed 115 patients with stage IB1 cervical cancer who underwent radical hysterectomy or radical trachelectomy. Magnetic resonance imaging (MRI) was performed and serum concentrations of squamous cell carcinoma antigen (SCC-Ag) and cancer antigen 125 (CA-125) were determined in all patients before initial treatment. The following pretreatment factors were investigated: histological variant, maximum tumor diameter, tumor volume (volume index), pelvic lymph node enlargement, and serum tumor markers. Logistic regression analysis was used to select the independent risk factors for PI.ResultsEighteen of the 115 patients (15.7%) were pathologically diagnosed with PI. Multivariate analysis confirmed the following independent risk factors for PI: MRI-based tumor diameter ≥25 mm (odds ratio [OR], 9.9; 95% confidence interval [CI], 2.1 to 48.1), MRI-based volume index ≥5,000 mm3 (OR, 13.3; 95% CI, 1.4 to 125.0), and positive serum tumor markers SCC-Ag ≥1.5 ng/mL or CA-125 ≥35 U/mL (OR, 5.7; 95% CI, 1.3 to 25.1). Of 53 patients with no risk factors for PI, none had PI.ConclusionLess radical surgery may become one of the treatment options for stage IB1 cervical cancer patients with MRI-based tumor diameter <25 mm, MRI-based volume index <5,000 mm3, and negativity for SCC-Ag and CA-125.

show abstract

“…Several studies have reported the oncologic outcomes of patients with early-stage cervical cancer who underwent less radical surgery, such as conization or simple hysterectomy [ 16 - 19 ]. To date, 260 women with conservatively managed early-stage cervical cancer have been described in the literature and oncologic outcomes are very favorable, with only two recurrences [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Identifying a low-risk group for parametrial involvement in microscopic Stage IB1 cervical cancer using criteria from ongoing studies and a new MRI criterion

et al. 2015

View full text Add to dashboard Cite

BackgroundThere are currently three ongoing studies on less radical surgery in cervical cancer: ConCerv, GOG-278, and SHAPE. The aim of this study was to evaluate the performance of the criteria used in ongoing studies retrospectively and suggest a new, simplified criterion in microscopic Stage IB1 cervical cancer.MethodsA retrospective analysis was performed in 125 Stage IB1 cervical cancer patients who had no clinically visible lesions and were allotted based on microscopic findings after conization. All patients had magnetic resonance imaging (MRI) after conization and underwent type C2 radical hysterectomy. We suggested an MRI criterion for less radical surgery candidates as patients who had no demonstrable lesions on MRI. The rates of parametrial involvement (PMI) were estimated for patients that satisfied the inclusion criteria for ongoing studies and the MRI criterion.ResultsThe rate of pathologic PMI was 5.6% (7/125) in the study population. ConCerv and GOG-278 identified 11 (8.8%) and 14 (11.2%) patients, respectively, as less radical surgery candidates, and there were no false negative cases. SHAPE and MRI criteria identified 78 (62.4%) and 74 (59.2%) patients, respectively, as less radical surgery candidates; 67 patients were identified as less radical surgery candidates by both sets of criteria. Of these 67 patients, only one had pathologic PMI with tumor emboli.ConclusionsThis study suggests that the criteria used in three ongoing studies and a new, simplified criterion using MRI can identify candidates for less radical surgery with acceptable false negativity in microscopic Stage IB1 disease.

show abstract

Small volume stage 1B1 cervical cancer

Cited by 60 publications

References 25 publications

Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?

Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?

Pretreatment risk factors for parametrial involvement in FIGO stage IB1 cervical cancer

Identifying a low-risk group for parametrial involvement in microscopic Stage IB1 cervical cancer using criteria from ongoing studies and a new MRI criterion

Contact Info

Product

Resources

About