Analysis of Prognostic Factors Affecting the Outcome of Stage IB-IIB Cervical Cancer Treated by Radical Hysterectomy and Pelvic Lymphadenectomy

Xia, Xi; Xu, Hongbin; Wang, Zhonghai; Liu, Ronghua; Hu, Ting; Li, Shuang

doi:10.1097/coc.0000000000000100

Cited by 17 publications

(9 citation statements)

References 24 publications

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“…[ 22 – 26 ] Kasamatsu et al [ 27 ] identified tumor size and node metastasis as independent prognostic factors for survival, and infiltration to vagina and node metastasis as independent prognostic factors for relapse. Xia et al [ 28 ] summarized parametrial invasion and pelvic node metastasis as independent prognostic factors for both survival and disease-free survival. In our study, FIGO stage was the most important prognostic parameter for ADC, with 5-year OS rates for patients with FIGO stage IA, IB, IIA, and IIB of 100.0%, 90.7%, 82.8%, and 55.6%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Postoperative clinicopathological factors affecting cervical adenocarcinoma

Zhou

Chen

et al. 2018

Medicine

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Currently, cervical adenocarcinoma (ADC) receives the same standard treatment as squamous cell carcinoma, but this treatment regimen is not wholly suited for ADC. The present study was conducted to assess the prognostic role of postoperative clinicopathological factors in patients with stage I–IIB cervical ADC.The study examined 312 patients with stage I–IIB cervical ADC who underwent radical hysterectomy, including pelvic lymphadenectomy, at our institutions between October 2006 and September 2014. Overall survival (OS) and relapse-free survival (RFS) was analyzed by the Kaplan–Meier method. Sites of recurrence were classified as local and distant locations.The 5-year OS and RFS rates were 88.2% and 83.8%, respectively. The 5-year OS rates for patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA, IB, IIA, and IIB were 100.0%, 90.7%, 82.8%, and 55.6%, respectively. The Cox model identified number of positive pelvic nodes and age at surgery as independent prognostic factors for survival, and number of positive pelvic nodes and postoperative tumor diameter (≥4 cm) as independent prognostic factors for relapse. Cancer recurrence developed in 35 women. The top three recurrence sites were pelvis, vaginal stump, and lung.A more aggressive therapeutic strategy different from current practice in cervical cancer is urgently required for cervical ADC. As a new prognostic factor, postoperative tumor diameter should receive special attention in ADC treatment.

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Section: Discussionmentioning

confidence: 99%

Postoperative clinicopathological factors affecting cervical adenocarcinoma

Zhou

Chen

et al. 2018

Medicine

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“…In cervical cancer, the tumor size, histological subtype, baseline hemoglobin, and involvement of pelvic or para-aortic lymph nodes have been identified to possess a prognostic value ( 10 – 14 ). Some studies have suggested that the lymph node positivity is one of the most prominent prognostic factors for recurrence and death in patients with cervical cancer ( 15 , 16 ). Conversely, other studies reported conflicting results that positive pelvic lymph nodes (PLNs) do not affect recurrence and survival ( 17 , 18 ).…”

Section: Introductionmentioning

confidence: 99%

Radiographic Number of Positive Pelvic Lymph Nodes as a Prognostic Factor in Cervical Cancer Treated With Definitive Concurrent Chemoradiotherapy or Intensity-Modulated Radiotherapy

et al. 2018

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Background: This study aims to assess the prognostic significance of radiographic numbers of positive pelvic lymph nodes (PLNs) in patients with cervical cancer treated with definitive concurrent chemoradiotherapy (CCRT) or intensity-modulated radiotherapy (IMRT).Methods: We conducted a retrospective study that included 164 eligible adult patients with cervical cancer who were treated with definitive CCRT or IMRT at our institution from 2009 to 2016. After exclusion of 50 patients, a total of 114 patients whose clinicopathological data and follow-up were finally analyzed. The radiographic numbers of positive PLNs were assessed by pretreatment magnetic resonance imaging (MRI) or computed tomography (CT). The criterion for a positive lymph node was defined as a short-axis diameter >1 cm. Using the Kaplan–Meier method and the Cox proportional hazards regression model, we assessed the overall survival (OS), cancer-specific survival (CSS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS).Results: The median follow-up duration was 40 (range: 2–100) months. For patients with 0, 1–2, and ≥3 positive PLNs, the estimated 3-year OS were 85.4% vs. 82.4% vs. 59.7% (p = 0.035), CSS were 90.1% vs. 86.1% vs. 62.9% (p = 0.010), DMFS were 89.4% vs. 91.3% vs. 49.6% (p < 0.001), and LRFS were 77.8% vs. 73.4% vs. 70% (p = 0.690). Per the multivariate Cox regression, positive PLNs ≥3 (HR, 2.51; 95% CI: 1.09–5.80; p = 0.031) and non-squamous cell carcinoma type (HR, 2.82; 95% CI: 1.19–6.69; p = 0.018) were unfavorable factors for the OS. Besides, positive PLNs ≥3 was the independent factor for the CSS (HR, 3.38; 95% CI: 1.32–8.67; p = 0.011) and DMFS (HR, 6.83; 95% CI: 2.62–17.83; p < 0.001). The patients that were treated without intracavitary brachytherapy exhibited inferior LRFS (HR, 13.15; 95% CI: 2.66–65.10; p = 0.002).Conclusions: The radiographic number of positive PLNs (≥ 3) is an independent prognostic factor for OS, CSS, and DMFS in patients treated with definitive CCRT or IMRT.

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“…Owing to the short life expectancy or survival of these patients and the fact that important personal decisions are influenced by prognosis information, it is important to identify predictive factors concerning life expectancy and oncological outcome. Several studies have identified prognostic factors for recurrent cervical cancer after primary treatment, including studies from the fields of immunohistochemistry and molecular biology [1,14,15], but much less is known about the prognostic factors for survival or the clinical aspects of recurrent cervical cancer, especially recurrent cervical cancer after RHND [4,5,10]. …”

Section: Introductionmentioning

confidence: 99%

Clinical Aspects and Prognostic Factors for Survival in Patients with Recurrent Cervical Cancer after Radical Hysterectomy

Hanprasertpong

Jiamset²,

Geater³

et al. 2016

Oncol Res Treat

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Background: The aim of this study was to investigate the clinical aspects and prognostic factors for survival in patients with recurrent cervical cancer after radical hysterectomy with node dissection (RHND) for stages IA2-IB1. Patients and Methods: Clinicopathologic characteristics of the primary tumor, pattern of recurrence, method of detection, salvage treatment, and outcome were reviewed from the medical records of patients who underwent RHND between 1987 and 2015. Prognostic factors were identified using a Cox regression model. Results: Of 702 patients enrolled in the study, 84 (11.9%) had recurrence. 58, 17, and 9 patients had locoregional, distant, and combined recurrence, respectively. No association between clinicopathologic features and recurrence patterns was observed. Most recurrence patients (63.1%) complained of symptoms prior to examination. The majority of asymptomatic recurrence patients (71.4%) were diagnosed by physical and/or pelvic examination. 5-year overall survival after recurrence (SAR) was 34.3%. On multivariate analysis, pattern of recurrence (p = 0.003), symptom status (p = 0.011), age (p = 0.035), and white blood cell (WBC) count (p = 0.017) were independent prognostic factors for overall SAR. Conclusion: Only pattern of recurrence, symptom status, age, and WBC count were found to be prognostic factors in recurrent cervical cancer after RHND. Follow-up programs after RHND should be directed toward early detection of recurrence.

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Analysis of Prognostic Factors Affecting the Outcome of Stage IB-IIB Cervical Cancer Treated by Radical Hysterectomy and Pelvic Lymphadenectomy

Abstract: Patients with combination of pelvic node metastasis and parametrial invasion have the poorest prognosis, and adjuvant therapy significantly increases DFS and OS rates among patients without parametrial invasion and pelvic node metastasis.

Cited by 17 publications

References 24 publications

Postoperative clinicopathological factors affecting cervical adenocarcinoma

Postoperative clinicopathological factors affecting cervical adenocarcinoma

Radiographic Number of Positive Pelvic Lymph Nodes as a Prognostic Factor in Cervical Cancer Treated With Definitive Concurrent Chemoradiotherapy or Intensity-Modulated Radiotherapy

Clinical Aspects and Prognostic Factors for Survival in Patients with Recurrent Cervical Cancer after Radical Hysterectomy

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