Adjuvant chemoradiation after laparoscopically assisted vaginal radical hysterectomy (LARVH) in patients with cervical cancer

Gruen, Arne; Musik, Thabea; Köhler, Christian; Füller, Jürgen; Wendt, Thomas; Stromberger, Carmen; Budach, Volker; Schneider, Achim; Marnitz, Simone

doi:10.1007/s00066-011-2197-7

Cited by 16 publications

(5 citation statements)

References 48 publications

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“…Our data support the assumption that this issue may be of special relevance in patients with pelvic lymph node metastases. Positive lymph nodes have been identified as main risk factor for local and distant relapse in this trial approved by others [17,8,34,14,11]. Also in a recently published trial, the survival benefit after radiochemotherapy was more prominent among patients with at least two positive nodes than in patients with only one nodal metastasis [26].…”

Section: Discussionmentioning

confidence: 91%

Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer

et al. 2012

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Section: Discussionmentioning

confidence: 91%

Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer

et al. 2012

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“…Physicians were reluctant to perform RH in patients with bulky early-stage cervical cancer based on these results. However, recent other reports found that the rates of serious toxicity were lower after RH+RT; the rate of toxicity of grades 3-4 was only 7%, being 2% and 3% in terms of gastrointestinal and genitourinary complications, respectively [13,16,25]. When we evaluated the occurrence of grade 3-4 toxicities that required treatment, we found that the rates of grade 3-4 early complications were not different between RH+RT group and CRT group (24.2% vs. 30.9%, p=0.342).…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes between radical hysterectomy followed by tailored adjuvant therapy versus primary chemoradiation therapy in IB2 and IIA2 cervical cancer

Kim

et al. 2012

J Gynecol Oncol

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ObjectiveTo compare survival outcomes and treatment-related morbidities between radical hysterectomy (RH) and primary chemoradiation therapy (CRT) in patients with bulky early-stage cervical cancer.MethodsWe selected 215 patients with stage IB2 and IIA2 cervical cancer (tumor diameter > 4 cm on magnetic resonance imaging) who underwent RH followed by tailored adjuvant therapy (n=147) or primary CRT (n=68) at two tertiary referral centers between 2001 and 2010.ResultsAbout twenty nine percent of patients were cured by RH alone and these patients experienced the best survival outcomes with the lowest morbidity rates. After the median follow-up times of 40 months, 27 RH (18.4%) and 20 CRT (29.4%) patients had recurrence (p=0.068) and 23 (15.6%) and 17 (25%) patients died of disease (p=0.101). The 5-year progression-free survival were 77% and 66% (p=0.047), and the 5-year overall survival were 78% and 67% (p=0.048) after RH and primary CRT, respectively. In multivariate analysis, patients who received primary CRT was at higher risk for tumor recurrence (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.24 to 4.14; p=0.008) and death (OR, 3.02; 95% CI, 1.53 to 5.98; p=0.001) than those who received RH. Grade 3-4, early (17% vs. 30.9%, p=0.021) and late (1.4% vs. 8.8%, p=0.007) complications were significantly less frequent after RH than primary CRT.ConclusionThirty percent of patients were cured by RH alone. A treatment outcome was better in this retrospective study in terms of morbidity and survival. Randomized trials are needed to confirm this result.

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“…Cervical squamous carcinoma (CSC) is the most common pathological type of UCC, accounting for 75-80% of the total number of cervical cancer patients [2]. Poorly differentiated CSCs can easily cause local invasion and distant metastasis, affecting the choice of treatment and prognosis of patients [3,4]. Therefore, it is important to accurately assess the grade of CSC before treatment.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of the value of amide proton transfer-weighted imaging and diffusion kurtosis imaging in evaluating the histological grade of cervical squamous carcinoma

et al. 2022

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Background Uterine cervical cancer (UCC) was the fourth leading cause of cancer death among women worldwide. The conventional MRI hardly revealing the microstructure information. This study aimed to compare the value of amide proton transfer-weighted imaging (APTWI) and diffusion kurtosis imaging (DKI) in evaluating the histological grade of cervical squamous carcinoma (CSC) in addition to routine diffusion-weighted imaging (DWI). Methods Forty-six patients with CSC underwent pelvic DKI and APTWI. The magnetization transfer ratio asymmetry (MTRasym), apparent diffusion coefficient (ADC), mean diffusivity (MD) and mean kurtosis (MK) were calculated and compared based on the histological grade. Correlation coefficients between each parameter and histological grade were calculated. Results The MTRasym and MK values of grade 1 (G1) were significantly lower than those of grade 2 (G2), and those parameters of G2 were significantly lower than those of grade 3 (G3). The MD and ADC values of G1 were significantly higher than those of G2, and those of G2 were significantly higher than those of G3. MTRasym and MK were both positively correlated with histological grade (r = 0.789 and 0.743, P < 0.001), while MD and ADC were both negatively correlated with histological grade (r = − 0.732 and - 0.644, P < 0.001). For the diagnosis of G1 and G2 CSCs, AUC (APTWI+DKI + DWI) > AUC (DKI + DWI) > AUC (APTWI+DKI) > AUC (APTWI+DWI) > AUC (MTRasym) > AUC (MK) > AUC (MD) > AUC (ADC), where the differences between AUC (APTWI+DKI + DWI), AUC (DKI + DWI) and AUC (ADC) were significant. For the diagnosis of G2 and G3 CSCs, AUC (APTWI+DKI + DWI) > AUC (APTWI+DWI) > AUC (APTWI+DKI) > AUC (DKI + DWI) > AUC (MTRasym) > AUC (MK) > AUC (MD > AUC (ADC), where the differences between AUC (APTWI+DKI + DWI), AUC (APTWI+DWI) and AUC (ADC) were significant. Conclusion Compared with DWI and DKI, APTWI is more effective in identifying the histological grades of CSC. APTWI is recommended as a supplementary scan to routine DWI in CSCs.

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Adjuvant chemoradiation after laparoscopically assisted vaginal radical hysterectomy (LARVH) in patients with cervical cancer

Abstract: With similar oncologic outcome data and mostly mild side effects, LARVH followed by (chemo)radiation is a valid alternative in the treatment of cervical cancer patients.

Cited by 16 publications

References 48 publications

Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer

Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer

Comparison of outcomes between radical hysterectomy followed by tailored adjuvant therapy versus primary chemoradiation therapy in IB2 and IIA2 cervical cancer

Comparative analysis of the value of amide proton transfer-weighted imaging and diffusion kurtosis imaging in evaluating the histological grade of cervical squamous carcinoma

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