Lower Body Lymphedema in Patients with Gynecologic Cancer

Biglia, Nicoletta; Zanfagnin, Valentina; Daniele, Alberto; Robba, Elisabetta; Bounous, Valentina Elisabetta

doi:10.21873/anticanres.11785

Cited by 49 publications

(56 citation statements)

References 61 publications

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“…Lymphatic metastasis is the main factor affecting the outcome of cervical carcinoma in early-stage SCC 13 - 15 . On one hand, micro-metastases are identifiable in histologically negative PLM in 15% of early-stage cervical cancer patients, a frequency that approximates the recurrence rate of patients with negative nodes 16 - 17 , on the other hand, lower body lymphedema is a significant cause of morbidity following the pelvic lymph node dissection that strongly impacts patients' quality of life (QoL) 18 . It is, therefore, important to identify positive PLM in patients with SCC in an early FIGO stage.…”

Section: Discussionmentioning

confidence: 99%

Preoperative SCC-Ag and thrombocytosis as predictive markers for pelvic lymphatic metastasis of squamous cervical cancer in early FIGO stage

Fan

et al. 2018

J. Cancer

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Objectives:To explore the clinical significance of squamous cell carcinoma antigen (SCC-Ag) and thrombocytosis to predict pelvic lymphatic metastasis (PLM) of squamous cervical cancer (SCC) in International Federation of Gynecology and Obstetrics (FIGO) stages IA-IIA.Methods:A retrospective clinicopathologic review of 782 patients of a primary cohort in three Chinese hospitals from 2010 to 2015, and 407 patients of a validation cohort in another institution from 2015 to 2017. A receiver operating characteristic curve was used to determine the optimal SCC-Ag threshold to predict PLM in the groups. Univariate and multivariate logistic analyses for PLM were performed to assess differences in outcome.Results:In the primary and validation cohort, 15.6% (122/782) and 25.3% (103/407) patients were classified into the thrombocytosis group (platelet count >300 × 109/L), respectively. Optimal cutoff values of SCC-Ag for predicting PLM of the thrombocytosis group and the normal group were 3.26 ng/mL (AUC 0.754; sensitivity 73.08%; specificity 72.92%; P = 0.000) and 4.58 ng/mL (AUC 0.706; sensitivity 53.26%; specificity 83.98%; P = 0.000), respectively, in the primary cohort, and 1.55 ng/mL (AUC 0.705; sensitivity 79.31%; specificity 55.41%; P = 0.000) and 1.75 ng/mL (AUC 0.655; sensitivity 69.57%; specificity 64.26%; P = 0.000), respectively, in the validation cohort. In multivariate logistic analysis, preoperative SCC-Ag over 3.26 ng/mL and lymphovascular space involvement were the significant predictors of PLM for SCC in FIGO stages IA-IIA.Conclusions: Preoperative SCC-Ag alone or combined with thrombocytosis might be used as predictive markers for PLM before initial treatment in early stage SCC.

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Section: Discussionmentioning

confidence: 99%

Preoperative SCC-Ag and thrombocytosis as predictive markers for pelvic lymphatic metastasis of squamous cervical cancer in early FIGO stage

Fan

et al. 2018

J. Cancer

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“…Lower Limb Lymphedema is the most frequent expression of lower body lymphedema and is generally observed in patients treated for gynaecologic malignancy or prostate cancer. Incidence and timing of secondary lower body lymphedema is variable depending on the study because there isn’t a uniform diagnostic definition [ 96 ].…”

Section: Physical Aspectsmentioning

confidence: 99%

“…The surgical therapy is a secondary option indicated in case of fail or strict adherence to complex decongestive therapy [ 97 ]. Medications such as diuretics are not indicated in the long-term treatment of lymphedema [ 96 ] and only in case of acute cellulitis the use of antibiotics is indicated. Skin care and education are important to prevent the risk of lymphedema [ 97 ].…”

Section: Physical Aspectsmentioning

confidence: 99%

Impact of physical exercise in cancer survivors during and after antineoplastic treatments

et al. 2018

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Cancer patients experience symptoms and adverse effects of treatments that may last even after the end of treatments. Exercise is a safe, non-pharmacological and cost-effective therapy that can provide several health benefits in cancer patient and survivors, reducing cancer symptoms and cancer treatment side effects. The purpose of this review is to describe how the physical exercise is capable to reduce cancer symptoms and cancer treatment side effects. We realized a pragmatic classification of symptoms, dividing them into physical, psychological and psycho-physical aspects. For each symptom we discuss causes, therapies, we analyse the effects of physical exercise and we summarize the most effective type of exercise to reduce the symptoms. This review also points out what are the difficulties that patients and survivors face during the practice of physical activity and provides some solutions to overcome these barriers.Related to each specific cancer, it emerges that type, frequency and intensity of physical exercise could be prescribed and supervised as a therapeutic program, like it occurs for the type, dose and duration of a drug treatment.

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“…To data, cervical cancer has been reported to be the second most common cancers in the department of gynecology [ 1 ]. Most of cervical cancer patients, especially patients with International Federation of Gynecology and Obstetrics (FIGO) IB2 stage, will develop the recurrence and distant metastasis [ 2 ]. As reported, various genes and proteins, such as the high mobility group box l [ 3 ], metastasis-associated 1 [ 4 ], Twist [ 5 ], were demonstrated to be related to the development of cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Silencing of BAG3 inhibits the epithelial-mesenchymal transition in human cervical cancer

Song

Wang

et al. 2017

Oncotarget

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Bcl2-associated athanogene 3 (BAG3) has been reported to be involved in aggressive progression of many tumors. In the present study, we examined the expression of BAG3 in human cervical cancer (CC) tissues and investigated the role of BAG3 in SiHa and HeLa cell growth, migration, and invasion. Here, we found that most of CC tissues highly expressed the protein and mRNA of BAG3, while their expression was obviously lower in paired normal tissues (all p<0.001). BAG3 expression was associated with FIGO stage and metastasis (all p<0.05). In-vitro analysis demonstrated that BAG3 siRNAs inhibited SiHa and HeLa cell growth, invasion and migration. Mechanically, BAG3 siRNAs inhibited the expression of EMT-regulating markers, involving MMP2, Slug and N-cadherin, and increased the expression of E-cadherin. In a xenograft nude model, BAG3 siRNAs inhibited tumor growth and the expression of EMT biomarkers. In conclusion, BAG3 is involved in the EMT process, including cell growth, invasion and migration in the development of CC. Thus, BAG3 target might be recommended as a novel therapeutic approach.

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Lower Body Lymphedema in Patients with Gynecologic Cancer

Cited by 49 publications

References 61 publications

Preoperative SCC-Ag and thrombocytosis as predictive markers for pelvic lymphatic metastasis of squamous cervical cancer in early FIGO stage

Preoperative SCC-Ag and thrombocytosis as predictive markers for pelvic lymphatic metastasis of squamous cervical cancer in early FIGO stage

Impact of physical exercise in cancer survivors during and after antineoplastic treatments

Silencing of BAG3 inhibits the epithelial-mesenchymal transition in human cervical cancer

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