The Selection of Time Interval Between Surgery and Adjuvant Therapy in Early Stage Cervical Cancer

You, Kaiyun; Zhou, Xinhui; Jiang, Yanjun; Bi, Zhuofei; Liu, Yimin; Qiu, Xingsheng

doi:10.1097/igc.0000000000001307

Cited by 8 publications

(4 citation statements)

References 19 publications

(18 reference statements)

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“…For early-stage CC, short TI from surgery to adjuvant CRT had better OS and DFS than long-interval patients, and TI was an independent predictor of DFS and local recurrence-free survival [ 22 , 30 ]. In our study, cox-multivariate analyses showed that TI from surgery to RT beyond 7 weeks was adverse independent prognostic factors for DFS.…”

Section: Discussionmentioning

confidence: 99%

“…Firstly, the surgical-related factors that result in poor patient survival, such as utilizing a uterine manipulator, the effect of insufflation gas (CO 2 ), and the degree of resection, can be improved by postoperative RT or CRT [18][19][20]. Secondly, many studies indicated that a longer adjuvant RT wait-time after RH result in poorer oncologic outcome in early-stage CC [21,22]. In LACC trial, there was no significant between-group difference in the time to initiation of any adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

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The impacts of minimally invasive surgery on intermediate- or high-risk cervical cancer patients received adjuvant radiotherapy

Zhang

Wang

et al. 2022

World J Surg Onc

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Background Adjuvant chemoradiotherapy (CRT) has been shown to reduce the risk of recurrence for patients with risk factors after radical hysterectomy (RH). Early initiated CRT could result in superior oncological outcomes. Here, we aimed to compare the survival outcome of intermediate- or high-risk cervical cancer (CC) patients who, received adjuvant CRT between minimally invasive surgery (MIS) and open surgery. Methods Data on stage IB1-IIA2 patients who underwent RH and postoperative CRT in our institution, from 2014 to 2017, were retrospectively collected. Patients with high or intermediate-risk factors who met the Sedlis criteria received sequential chemoradiation (SCRT). According to the surgical approaches, the enrolled patients were divided into MIS and open surgery groups. Then, the disease-free survival (DFS), overall survival (OS), and prognostic factors were analyzed. Results Among 129 enrolled CC patients, 68 received open surgery and 61 received MIS. The median time interval from surgery to chemotherapy and to radiotherapy was shorter in the MIS group (7 days vs. 8 days, P=0.014; 28 days vs. 35, P<0.001). Three-year DFS and OS were similar in both groups (85.2% vs. 89.7%, P=0.274; 89.9% vs. 98.5%, P=0.499). Further, sub-analysis indicated that the DFS and OS in intermediate/high-risk groups had no significant difference. Cox-multivariate analyses found that tumor size >4 cm and time interval from surgery to radiotherapy beyond 7 weeks were adverse independent prognostic factors for DFS. Conclusion Based on the population we studied, for early-stage (IB1-IIA2) CC patients with intermediate- or high-risk factors who received postoperative SCRT, although the difference was not significant, the DFS and OS in the MIS group were slightly lower than the ORH group, and tumor size >4 cm and delayed adjuvant radiotherapy beyond 7 weeks were risk factors for recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impacts of minimally invasive surgery on intermediate- or high-risk cervical cancer patients received adjuvant radiotherapy

Zhang

Wang

et al. 2022

World J Surg Onc

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“…In a retrospective study of 226 patients with early stage cervical cancer, You KY, et al [19] similarly investigated the clinical significance of interval from surgery to adjuvant therapy by first dividing patients into two cohorts by FIGO staging -IA2-IB1 and IB2-IIA [10]. They concluded that for patients with stage IB2-IIA disease, overall survival and disease-free survival were higher for patients who had an interval to adjuvant treatment less than 5 weeks, but no similar effect was observed for patients with earlier stage disease [19].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Primary Surgical Technique for Treatment of Endometrial Cancer and Timing of Adjuvant Radiation Therapy

Schwartz

Tomita

Kolev

et al. 2019

WJGWH

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This work is licensed under Creative Commons Attribution 4.0 License WJGWH.MS.ID.000553. Introduction Endometrial cancer (EC) is the most common gynecologic malignancy in the United States, accounting for an estimated 63,230 new cases and 11,530 deaths in 2018 [1]. Women with endometrial cancer undergo surgical staging followed by adjuvant treatment as appropriate. Adjuvant radiotherapy (RT) is commonly used for patients with early-stage high-intermediate risk disease or those with advanced disease in order to prevent locoregional recurrence. The locoregional recurrence rate for early stage endometrial cancer with risk factors is up to 26% [2,3]. For patients with advanced stage disease, despite receiving systemic chemotherapy, up to 18% of patients will develop a locoregional recurrence [4]. When feasible, minimally invasive surgery is the preferred surgical modality for EC staging and treatment [5]. Laparoscopic surgical management for EC has been shown to be a safe alternative to laparotomy. Laparoscopy as compared to open techniques results in fewer short-term complications and decreased hospital length of stay [6] with similar oncological outcomes [5,7]. A meta-analysis of the literature comparing robotic-assisted laparoscopic surgery to laparotomy for EC also revealed decreased intraoperative and postoperative complication rates, decreased postoperative morbidity, improved patient-reported outcomes, including significantly shorter return to daily activities, and equivalent

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“…This is a new technique for minimally invasive surgery. It has many advantages, provides convenience for gynecological tumor patients, and has good application prospects in gynecological surgery [ 20 , 21 ]. With its further development, it is expected to overcome its shortcomings in the future, such as long preoperative preparation work, large equipment, complex installation, and high cost.…”

Section: Methods Of Research On the Impact Of Urinary Tract Injury Du...mentioning

confidence: 99%

Manifestation of Urinary Tract Injury during Cervical Cancer Surgery Based on CT Urography Secretion Phase Images

Song

Zhang

et al. 2022

Contrast Media & Molecular Imaging

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Object. CT imaging can be processed by computer, and the absorption coefficient of each voxel to X-ray can be obtained by calculation, which can effectively improve the efficiency of surgery. Traditional treatment is based on the patient’s age, fertility requirements, and general conditions, often using a comprehensive treatment plan with surgery and radiotherapy as the mainstay, supplemented by chemotherapy, which has great limitations and side effects, in order to alleviate the loss of various body functions, especially the urinary tract during cervical cancer surgery. Methods. We grouped the patients who had undergone cervical cancer surgery in a hospital in this article and compared the nanodrug carrier system under CT imaging with traditional laparoscopy. The postoperative physical parameters of surgical patients are collected from cervical cancer patients of different degrees, and the parameters and prognostic health of patients after different operations are compared. Results. The results of the study show that the postoperative patient’s body parameters of the nanodrug delivery system under the CT imaging technology used in this article are better than those of the traditional surgery group, and the average intraoperative blood loss is about 20% less than that of the traditional surgery. Postoperative complications occur. The situation is even lower, more than 30% lower than traditional surgery. Conclusion. This shows that the operation of the nanodrug delivery system based on CT imaging technology has broken through some of the limitations of the development of laparoscopic technology and has played an important role in the surgical treatment of cervical cancer.

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The Selection of Time Interval Between Surgery and Adjuvant Therapy in Early Stage Cervical Cancer

Cited by 8 publications

References 19 publications

The impacts of minimally invasive surgery on intermediate- or high-risk cervical cancer patients received adjuvant radiotherapy

The impacts of minimally invasive surgery on intermediate- or high-risk cervical cancer patients received adjuvant radiotherapy

The Effect of Primary Surgical Technique for Treatment of Endometrial Cancer and Timing of Adjuvant Radiation Therapy

Manifestation of Urinary Tract Injury during Cervical Cancer Surgery Based on CT Urography Secretion Phase Images

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