Background. The benefit of postoperative adjuvant therapy for patients with cervical cancer is uncertain, and moreover, may increase morbidity. In this study, patient age, clinical stage of the cancer, tumor size, and levels of serum squamous cell carcinoma cell antigen and carcinoembryonic antigen were studied in patients with Stage Ib and IIa squamous cell carcinoma of the uterine cervix to determine if these parameters can be used, be fore the surgical intervention, to distinguish patients who require postoperative adjuvant therapy from those who do not. Methods. Ninety‐nine patients were studied. After surgery, patients were classified either as high risk or low risk according to the results of histopathologic findings. The age of the patient was noted, and FIGO stage, squamous cell carcinoma antigen, carcinoembryonic antigen, and clinical tumor size were determined. A univariate analysis and then a stepwise logistic regression procedure were performed to select significant clinical predictors from among the five variables mentioned above. Any selected predictors were further analyzed by the receiver operator characteristic curve. Results. Serum squamous cell carcinoma antigen and clinical tumor size measured by colposcopic examination were significant clinical predictors of the treatment strategy postoperatively. From the receiver operator characteristic curve, a sensitivity of 84.2%, a specificity of 91.8%, a positive predictive value of 84.5% were attained. Conclusions. Serum squamous cell carcinoma antigen assays and clinical tumor size estimated by colpos copic examination are helpful in identifying patients who require postoperative adjunctive therapy.
Figure 1. -MRI T2-weighted image of a large polypoid heterogeneous hyperintensity tumor in the uterine cervix with vaginal lumen protrusion and urinary bladder compression, free of endometrium. SummaryUndifferentiated endometrial sarcoma is an aggressive sarcoma. The authors report a case of such a large tumor arising from the cervix in a 53-year-old multiparous woman presenting with urinary retention and vaginal bleeding. Ultrasound and Doppler imaging revealed a large mass about 13.3×7.6 cm in the cervix. MRI revealed a large polypoid heterogeneous hyperintensity tumor (12.2×8.2 cm) in the cervix with vaginal lumen protrusion and urinary bladder compression. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The pathology revealed FIGO Stage IIb. Adjuvant radiotherapy and chemotherapy with doxorubicin were given. The patient tolerated the treatment well, and so far she has no evidence of recurrence.
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