Clinical outcome of recurrent locally advanced cervical cancer (LACC) submitted to primary multimodality therapies

Legge, Francesco; Chiàntera, Vito; Macchia, G.; Fagotti, Anna; Fanfani, Francesco; Ercoli, Alfredo; Gallotta, Valerio; Morganti, Alessio Giuseppe; Valentini, Vincenzo; Scambia, Giovanni; Ferrandina, Gabriella

doi:10.1016/j.ygyno.2015.04.035

Cited by 45 publications

(47 citation statements)

References 33 publications

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“…In this study, we analyzed clinical outcomes of patients with RUCC in our institute and evaluated prognostic factors concerning PRS instead of overall survival (OS) or progression-free survival (PFS). The recurrence rate of all the patients was 22.3%, which was consistent with previous reports (8)(9)(10)(11)(12). As expected, patients who experienced recurrence had an extremely poor prognosis (median PRS of 28.4 months and 5-year PRS rate of 32.1%).…”

Section: Discussionsupporting

confidence: 91%

“…Therefore, surgical intervention is considered a favorable treatment for local cervical carcinoma. Furthermore, some reports showed an impact of the surgical procedure on advanced or recurrent cervical cancer (8,15).…”

Section: Discussionmentioning

confidence: 99%

“…Legge et al reported that the median survival of patients with visceral (e.g., lungs, bones, liver, brain) or lymph nodal metastatic relapse was significantly better compared with that in patients with pelvic recurrence (8). By contrast, other reports concluded that pelvic recurrence could be salvaged with CCRT in patients who were not initially treated with radiation therapy, and that central pelvic recurrence might be salvaged with pelvic exenteration (16-18).…”

Section: Discussionmentioning

confidence: 99%

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A post-recurrence survival‑predicting indicator for cervical cancer from the analysis of 165ï¿½patients who developed recurrence

et al. 2017

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Abstract. The aim of the present study was to estimate the post-recurrence survival (PRS) of patients with relapsed uterine cervical cancer (RUCC). In addition, clinicopathological indicators that influenced PRS were investigated. Between 1998 and 2014, of 740 patients with cervical cancer, 165 patients experienced recurrence (recurrence rate, 22.3%), and 83 patients succumbed to the disease within a median follow-up of 34.3 months. A total of 151 stage Ib-IV patients who experienced recurrence after initial treatment for cervical cancer at our institute were analyzed. Uni-and multivariate analyses were performed using the Kaplan Meier method, and Cox regression model. The median age was 55 years (range, 20-88 years). In all, 80 patients succumbed to the disease. The median PRS time of all the patients was 28.4 months. The 1-, 3-, and 5-year PRS rates of patients were 75.1, 41.9, and 32.1%, respectively. In addition, the median survival period in patients who had received surgery as an initial treatment was significantly longer compared with that in patients who had not previously undergone surgery (36.7 vs. 23.3 months, respectively; P=0.0338). Following the univariate analysis, the median PRS in patients with in-and out-field recurrence was 12.6, and 45.9 months, respectively (P<0.0001). Furthermore, in the multivariable analysis, the recurrence site was a significant prognostic indicator of PRS [(In-field vs. Out-field); hazard ratio, 2.848; 95% confidence interval, 1.707-4.738; P<0.0001]. The long-term clinical outcome of patients with RUCC was poor. In particular, the in-field recurrence was identified to be associated with poor post-recurrence oncological outcome in patients with RUCC.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A post-recurrence survival‑predicting indicator for cervical cancer from the analysis of 165ï¿½patients who developed recurrence

et al. 2017

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“…A systematic review including 9 studies reported that 62-89% of cervical cancer recurrences were detected within 2 years of the primary treatment (surgery or radiation therapy or concurrent chemoradiation) [2]. The length of the interval between completion of primary treatment and recurrence is considered by most physicians to be the most important prognostic factor for SAR [12], although some studies have disagreed with this [6,13]. In addition, several studies have suggested that the pattern of recurrence, in terms of site of recurrence and disease extension, affects SAR [4,5,6,13].…”

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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“…Several international clinical trials have reported that adjuvant radiotherapy or concurrent chemoradiation therapy can improve disease-free survival and overall survival outcomes in patients with pathological risk factors for recurrence (3)(4)(5). However, radiotherapy ultimately fails in >20% of patients with locally advanced cervical cancer (FIGO stage IB2-IVA), the main cause of which is radio-resistance (6,7). Clinically, the identification and treatment of radio-resistant cervical cancer remains a challenge.…”

Section: Introductionmentioning

confidence: 99%

Downregulation of eukaryotic initiation factor 4A1 improves radiosensitivity by delaying DNA double strand break repair in cervical cancer

Liang

Zhou

et al. 2017

Oncol Lett

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Abstract. Expression of eukaryotic initiation factor 4A1 (eIF4A1) following brachytherapy has been reported to predict improved radiosensitivity and tumor-specific survival in cervical cancer. Therefore, the present study investigated the function of eIF4A1 in cervical cancer and the mechanism by which eIF4A1 regulates cervical cancer radiosensitivity. It was determined that the downregulation of eIF4A1 in HeLa and SiHa cells notably attenuated cell proliferation, in addition to repressing cervical cancer migration and invasion, and promoting cell apoptosis. In vitro and in vivo studies have demonstrated that silencing eIF4A1 improves cervical cancer radiosensitivity. Detection of γ-H2AX using western blot analysis at 0, 0.5, 1, 6 and 24 h following the exposure of cervical cancer cells to X-rays illustrated that eIF4A1-knockdown results in postponed radiation-induced DNA double strand break (DSB) repair. Overall, the results of the present study demonstrated that downregulated eIF4A1 improves cervical cancer radiosensitivity by delaying cancer cell DSB repair. In conclusion, the data indicated that eIF4A1 performs a vital role in cervical cancer progression and radiosensitivity. Therefore, eIF4A1 may be a potential therapeutic target in patients with cervical cancer. IntroductionAlthough the incidence of cervical cancer has decreased due to more regular cytological screening programs and the success of human papillomavirus vaccinations, it remains the third most common type of gynecological cancer worldwide (1).The International Agency for Research on Cancer estimated there were 528,000 new cases and 266,000 deaths in 2012, and a total of ~9/10 (87%) of cervical cancer mortalities occur in less developed regions (2). At present, radiotherapy, as an adjuvant or primary treatment, remains the most common and effective therapeutic intervention for cervical cancer. Several international clinical trials have reported that adjuvant radiotherapy or concurrent chemoradiation therapy can improve disease-free survival and overall survival outcomes in patients with pathological risk factors for recurrence (3-5). However, radiotherapy ultimately fails in >20% of patients with locally advanced cervical cancer (FIGO stage IB2-IVA), the main cause of which is radio-resistance (6,7). Clinically, the identification and treatment of radio-resistant cervical cancer remains a challenge.Eukaryotic initiation factor (eIF) 4F is composed of ATP-dependent RNA helicase eIF4A1, 5' cap mRNA-binding protein eIF4E and the scaffolding protein eIF4G, which scans mRNAs through the 5' untranslated region (5'UTR), and unwinds the mRNA secondary structure to expose the translation initiation codon and initiates translation (8,9). Assembly of the eIF4F complex is rate-limiting step for translation initiation. Increased eIF4F complex formation elevates the translation of all cap-dependent mRNAs, thereby increasing global protein synthesis rates. However, mRNAs vary widely in their inherent translatability, largely as a function of differences in t...

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Clinical outcome of recurrent locally advanced cervical cancer (LACC) submitted to primary multimodality therapies

Cited by 45 publications

References 33 publications

A post-recurrence survival‑predicting indicator for cervical cancer from the analysis of 165ï¿½patients who developed recurrence

A post-recurrence survival‑predicting indicator for cervical cancer from the analysis of 165ï¿½patients who developed recurrence

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

Downregulation of eukaryotic initiation factor 4A1 improves radiosensitivity by delaying DNA double strand break repair in cervical cancer

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