Surgical treatment of stage IA2 cervical cancer

Kokka, Fani; Bryant, Andrew; Brockbank, Elly; Jeyarajah, Arjun

doi:10.1002/14651858.cd010870.pub2

Cited by 26 publications

(23 citation statements)

References 42 publications

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“…2 In the field of fertility preservation for early-stage cervical cancer (which is well documented and widely performed), even if comparative retrospective studies were published, there would be no strong evidence that any form of surgical technique is better, equal, or worse in prolonging survival. 29 Ovarian preservation seems to be safe in patients with grade 2 or 3 EC confined to the endometrium. On the contrary, the results of this study show that uterine preservation increases the risk of mortality; therefore, careful and timelimited fertility-sparing management in patients with grade 2 or 3 EC is warranted.…”

Section: Discussionmentioning

confidence: 98%

Impact of Conservative Managements in Young Women With Grade 2 or 3 Endometrial Adenocarcinoma Confined to the Endometrium

Gonthier

Trefoux-Bourdet

Koskas³

2017

International Journal of Gynecological Cancer

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Section: Discussionmentioning

confidence: 98%

Impact of Conservative Managements in Young Women With Grade 2 or 3 Endometrial Adenocarcinoma Confined to the Endometrium

Gonthier

Trefoux-Bourdet

Koskas³

2017

International Journal of Gynecological Cancer

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“…Cervical cancer, commonly induced by chronic infection of human papillomaviruses (HPV), is the major cause of death in gynecological cancers and accounts for almost 12 % of all cancers among women worldwide [1][2][3]. Squamous cell carcinoma (SCC) represents the predominant subtype of cervical cancer [4].…”

Section: Introductionmentioning

confidence: 99%

Sex-determining region Y-related high mobility group box (SOX)-2 is overexpressed in cervical squamous cell carcinoma and contributes cervical cancer cell migration and invasion in vitro

et al. 2015

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Sex-determining region Y-related high mobility group box 2 (SOX-2) is a key pluripotency-associated transcription factor and may be implicated in the pathogenesis of cervical squamous cell carcinoma (SCC). The aim of this study was to explore SOX-2 expression in cervical SCC tissues and to examine whether and how SOX-2 regulates the malignant behaviors of cervical SCC cells in vitro. We here found that SOX-2 expression in the examined cervical SCC tissues was higher than that in the normal cervical and cervical intraepithelial neoplasia (CIN) tissues. Higher protein level of SOX-2 (nuclear positive staining cells ≥50 %) was detected in 34.9 % (29 out of 83 cases) of cervical SCC patients. We also noted that 100 % of well-differentiated and 66.7 % of moderately differentiated cervical SCCs showed lower SOX-2 expression (nuclear positive staining cells <50 %), while 58.8 % of poorly differentiated tumors had higher SOX-2 expression (P < 0.05). Furthermore, the migratory and invasive capabilities of SiHa cervical cancer cells were enhanced when SOX-2 was upregulated whereas suppressed when SOX-2 was downregulated. Also, the phosphorylation levels of protein kinase B (Akt) and extracellular regulated protein kinases (ERK) 1/2 were increased in SOX-2-overexpressed cancer cells but decreased in SOX-2-depleted cells. Additionally, LY294002 (Akt pathway inhibitor) or U0126 (ERK pathway inhibitor) significantly suppressed SOX-2-overexpression-induced migration and invasion in SiHa cells. Our results indicate that differentially expressed SOX-2 is associated with tumor differentiation (P < 0.05) and that SOX-2 contributes to the migratory and invasive behaviors of cervical SCC in vitro.

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“…Multiple reviews and retrospective studies offer widespread agreement that for selected cervical tumours (<2 cm in size, with no lymphovascular space invasion) there is low risk (0.6–3%) of parametrial involvement, with SVT offering a potentially equivalent oncological outcome 16–19. However, a Cochrane review by Kokka et al 20 suggested that no conclusions regarding effectiveness and safety could be confidently reached due to the absence of randomised trials. In the context of carefully assessed cervical premalignancy where parametrial and vaginal margins are not relevant, the authors would extrapolate that SVT represents a safe alternative to simple hysterectomy, in the same way that RVT offers a safe alternative to radical hysterectomy for small 1b1 cervical tumours.…”

Section: Discussionmentioning

confidence: 99%

Simple vaginal trachelectomy as a fertility-sparing treatment to manage high-grade dyskaryosis following multiple large loop excision of the transformation zone

2016

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SUMMARYA 34-year-old nullipara, wishing to start a family, presented to colposcopy clinic. Her most recent cervical cytology result showed high-grade dyskaryosis. Having undergone four large loop excisions of the transformation zone during the past 6 years, this woman had no remaining vaginal cervix. In order to excise presumed high-grade cervical intraepithelial neoplasia while mitigating obstetric risk, she underwent a simple vaginal trachelectomy and isthmic cerclage. 6 months later, the patient had a negative test of cure. 7 months following surgery she became pregnant naturally. At 29 weeks she had antenatal sepsis of unknown cause, which was treated with intravenous antibiotics. She delivered by caesarean section at 37 weeks and now has a healthy child. This report will discuss the obstetric impact of colposcopic treatment, and simple vaginal trachelectomy as a fertility-sparing treatment option for women who have had multiple loop excision procedures to treat premalignant lesions. BACKGROUND

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Surgical treatment of stage IA2 cervical cancer

Abstract: We found no evidence to inform decisions about different surgical techniques in women with stage IA2 cervical cancer. In the future, the results of one large ongoing RCT should allow comparison of different types of surgery.

Cited by 26 publications

References 42 publications

Impact of Conservative Managements in Young Women With Grade 2 or 3 Endometrial Adenocarcinoma Confined to the Endometrium

Impact of Conservative Managements in Young Women With Grade 2 or 3 Endometrial Adenocarcinoma Confined to the Endometrium

Sex-determining region Y-related high mobility group box (SOX)-2 is overexpressed in cervical squamous cell carcinoma and contributes cervical cancer cell migration and invasion in vitro

Simple vaginal trachelectomy as a fertility-sparing treatment to manage high-grade dyskaryosis following multiple large loop excision of the transformation zone

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