Glassy cell carcinoma of the uterine cervix responsive to neoadjuvant intraarterial chemotherapy

Abstract

Described as a poorly differentiated adenosquamous cancer, glassy cell carcinoma of the uterine cervix is a rare disease considered to have an extremely poor prognosis. Saitama Medical Center has been offering neoadjuvant intraarterial chemotherapy (NAC) to cervical cancer patients as a means of avoiding postoperative radiation therapy, achieving downstaging, and improving prognosis. We report a patient with glassy cell carcinoma of the uterine cervix who responded to NAC, and we discuss this case with reference to reports in the literature. A 28-year-old gravida 1, para 0 patient was referred to the Department of Obstetrics and Gynecology at Saitama Medical Center for concurrent cervical cancer at 23.5 gestational weeks. The patient was admitted to our center following the diagnosis of stage IIb cervical cancer (glassy cell carcinoma), to await fetal development, and an elective cesarean section was performed at slightly more than 29 gestational weeks. Three cycles of NAC with carboplatin (CBDCA)/etoposide/epirubicin, started 3 days after the operation, shrank the tumor remarkably. An extended radical hysterectomy was subsequently performed. It has been 6 years, to date, since the initial treatment, and our patient is alive and disease/recurrence free.

Carcinomatous meningitis from recurrent glassy cell carcinoma of the uterine cervix—A case report

“…Its prognosis is poor due to its resistance to radiotherapy and chemotherapy, rapid progression, and recurrence tendency. [11][12][13] Although there have been reports of successful chemotherapy and radiotherapy, [13][14][15] surgery and postoperative CCRT were chosen in this case because of the difficulty of intracavitary radiotherapy; subsequently, a disease-free-interval of 9 months was achieved. Thus, treatment should be decided based on each case due to the lack of an exclusive one.…”

Neoadjuvant Platinum-based Chemotherapy Followed by Radical Hysterectomy for Stage Ib2-IIb Adenocarcinoma of the Uterine Cervix – An Italian Multicenter Retrospective Study

“…Platinum-based NACT followed by radical hysterectomy has obtained good results in stage Ib2-IIb squamous cell carcinoma of the uterine cervix (6)(7)(8)11,(13)(14)(15), whereas few data are currently available about the efficacy of this chemosurgical treatment in cervical adenocarcinoma, with clinical overall response rates ranging from 50% to 93% (34,(36)(37)(38)(39)(40)(41)(42) (Table IV). Pooled data from three consecutive trials using different regimens showed a 5-year overall survival rate of 84% in the 33 responding patients, whereas all 9 nonresponders died after a median of 10 months (p<0.0001) (36).…”

“…Clinical studies regarding NACT followed by radical surgery have usually included patients with cervical squamous cell carcinoma (6-8, 11, 13, 15) or with cervical carcinoma of any histological type mainly consisting of squamous cell carcinoma (9,12,14,16,(28)(29)(30)(31)(32)(33)(34)(35), whereas very few studies have selectively investigated this therapeutic approach in patients with cervical adenocarcinoma (36)(37)(38)(39)(40)(41)(42). Some authors suggested that non-squamous carcinoma was associated with a lower response rate to NACT than squamous cell carcinoma (14,28,29), but others did not confirm these observations (30,31,33,34).…”

Carcinome à cellule vitreuse du col de l’utérus: à propos d’un cas et revue de littérature

“…De façon intéressante, dans le stade II de la maladie la combinaison de radiation et la chimiothérapie semble améliorer le résultat de survie. Le taux de récidives tardives était 33% pour des patients a traité avec la chirurgie, 3% pour des patients ont traité avec la radiation et 0% pour des patients ont traité avec radio-chimiothérapie [ 16 , 17 ]. Dans l’étude par Duenas et al la chimiothérapie adjuvante avec cisplatin et gemcitabine a diminué les récidives et a amélioré en général la progression la survie globale des malades avec stade II-IV le cancer du col de l'utérus aux dépens de la toxicité accrue mais cliniquement gérable [ 16 ].…”