Therapeutic Implications of Patterns of Recurrence in Cancer of the Uterine Cervix

Nagell, J.R. van; Rayburn, W F; Donaldson, Elvis S.; Hanson, M.; Gay, E. C.; Yoneda, J.; Marayuma, Y.; Powell, D.F.

doi:10.1097/00006254-198005000-00024

Cited by 16 publications

(22 citation statements)

References 1 publication

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“…In the present study, 50.54%% cases belonged to stage IIIB followed by stage II which accounted for 17.5% of cases. This finding was supported by studies by Van Nagell et al [10] and K Geetha…”

Section: Discussionsupporting

confidence: 78%

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Patterns of Distant Failure in Carcinoma Cervix- A Regional Cancer Centre Experience

Padhi¹

2016

jmscr

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Section: Discussionsupporting

confidence: 78%

“…stage III) had a higher failure rate. [10,11] According to Gadducci et al, [12] the most common extra-pelvic metastases involve para-aortic lymph nodes, lungs, liver and bone. In our study the most common site of distant failure was para-aortic node followed by lungs.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Distant Failure in Carcinoma Cervix- A Regional Cancer Centre Experience

Padhi¹

2016

jmscr

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“…The determination of pelvic disease-free survival, therefore, allows the most discriminating assessment of the relationship between tumour cell kinetics and radiotherapy response. This analysis based on a median survival of 34 months should provide an accurate prediction of local recurrence rate; in 78% of women destined to develop pelvic recurrence a diagnosis will be made within 24 months of treatment (Van Nagell et al, 1979).…”

Section: Calculated Cell Kinetic Parametersmentioning

confidence: 99%

Prediction of radiotherapy response of cervical carcinoma through measurement of proliferation rate

Bolger

Symonds²,

Stanton³

et al. 1996

Br J Cancer

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Summary Estimation of tumour proliferation may allow the design of individualised radiotherapy schedules to optimise response. This prospective study correlates the tumour proliferation rate of cervical carcinoma with response to conventional radiotherapy. The potential tumour cell doubling rate (Tpot) was estimated following flash labelling of the tumours in vivo using the DNA precursor, bromodeoxyuridine (BrdUrd); samples were analysed by flow cytometry. Tumour ploidy, DNA index and mitotic count were also assessed as was histological grade and type. Multiple biopsies from each tumour were obtained from 121 women. The median Tpot was 4.0 days, median S-phase duration 12.8 h and median adjusted labelling index 9.8%. Higher BrdUrd labelling was seen in patients who developed pelvic tumour recurrence following radiotherapy. This was the only biological/histological parameter with univariate and multivariate significance in relation to locoregional recurrence (P = 0.006 and P = 0.034 respectively). This study represents the first assessment of Tpot in relation to long-term response of cervical tumours treated by radiotherapy treatment. The association of high BrdUrd labelling and poor pelvic disease-free survival indicates the need for further research into the potential of radiotherapy schedule alteration to reflect tumour proliferation. The predictive value may be enhanced by combination with other biological parameters.Keywords: cervical carcinoma; radiotherapy; proliferation rate; bromodeoxyuridine Local recurrence can be a significant problem following radiotherapy for carcinoma of the cervix. This is particularly true of more advanced stage tumours. Local recurrence is seen in only 10% of stage lb patients, but in stage IIIb disease, pelvic recurrence rate is greater than 40% (Davidson et al., 1989). Both clinical and laboratory data suggest repopulation during treatment may be an important factor leading to failure to achieve local control of the tumour (Trott and Kummermehr, 1985). In order to reduce repopulation during treatment, radiotherapy can be given over a shorter time period, often two or three times a day using a fraction size of less than 2 Gy. It is unclear whether all patients would benefit from accelerated radiotherapy schedules. Initial results from a randomised study of radiotherapy schedule alteration in head and neck cancer (Saunders et al., 1991) suggest that local control is improved in patients receiving accelerated hyperfractionated radiotherapy in rapidly proliferating tumours only (Begg et al., 1992). Measurement of tumour proliferation rate may, therefore, help to select patients most likely to benefit from new or accelerated schedules for radiotherapy.There is inconclusive evidence regarding the relationship between measured tumour proliferation parameters and prognosis in cervical carcinoma (Dixon et al., 1977; Strang et al., 1987a,b;Naus and Zimmerman, 1991;Cole et al., 1992;Zanetta et al., 1992;Tsang et al., 1995). The techniques used in the measurement of proliferation in the...

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“…13 The three main metastatic sites are: pelvic ganglia, lung and liver. [14][15][16] For the most part, metastatic cervical carcinoma is not curable.…”

Section: Discussionmentioning

confidence: 99%

Relapse of cervical cancer 12 years after the treatment

Enes

Brandão

Rocha

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Cervical cancer is the third most common gynecologic cancer in women and it remains one of the main causes of death. With rare exceptions, it results from an HPV infection and about 5% of this infection will culminate in the development of CIN 2 or CIN 3 lesions. After treatment with surgery or radiotherapy, 10 to 20% of the patients will have a relapse and/or metastases usually in the first two years after completing their treatment. In this article, we present a clinical case of a lymph node relapse 12 years after treatment in a 43-year-old patient with a microinvasive cervical cancer history, Figo stage IA1, without lymphovascular invasion.

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Therapeutic Implications of Patterns of Recurrence in Cancer of the Uterine Cervix

Cited by 16 publications

References 1 publication

Patterns of Distant Failure in Carcinoma Cervix- A Regional Cancer Centre Experience

Patterns of Distant Failure in Carcinoma Cervix- A Regional Cancer Centre Experience

Prediction of radiotherapy response of cervical carcinoma through measurement of proliferation rate

Relapse of cervical cancer 12 years after the treatment

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