Neoadjuvant brachytherapy and chemotherapy followed by radical surgery in stage IB2 and IIA cervical cancer: A retrospective comparison with chemoirradiation

Ma, Yaomei

doi:10.1016/j.ygyno.2015.01.179

Cited by 4 publications

(5 citation statements)

References 26 publications

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“…Although the neoadjuvant therapy to surgery is not a standard therapy for FIGO IB-IIA patients, neoadjuvant chemotherapy to surgery has been evaluated by two randomized phase III clinical trial (NCT00193739 and EORTC Protocol 55994, no results available yet) [6] and it was permitted in National…”

Section: Discussionmentioning

confidence: 99%

“…The primary treatment strategy for patients with early-stage cervical cancers, particularly stage IA-IB1, is radical hysterectomy with or without radiation or chemotherapy [2,4]. Multiple treatment regimens have been actively explored and proposed for high-risk early-stage (stage IB-IIA) cervical cancer patients [5,6]. Neoadjuvant brachytherapy and chemotherapy followed by radical surgery showed an e cacy non-inferior to standard chemoradiation treatment and a more favorable toxicity pro le in stage IB2-IIA cervical cancer [6].…”

Section: Introductionmentioning

confidence: 99%

“…Multiple treatment regimens have been actively explored and proposed for high-risk early-stage (stage IB-IIA) cervical cancer patients [5,6]. Neoadjuvant brachytherapy and chemotherapy followed by radical surgery showed an e cacy non-inferior to standard chemoradiation treatment and a more favorable toxicity pro le in stage IB2-IIA cervical cancer [6]. Despite high disease-free survival rate (90% during 52 months of median follow-up time), there is a portion of patients who failed to respond to the therapy.…”

Section: Introductionmentioning

confidence: 99%

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WITHDRAWN: Multimodal genetic features correlate with poor response to neoadjuvant chemoradiotherapy and high recurrence risk in Chinese patients with stage IB-IIA cervical cancer

Wei

Chen

et al. 2020

Preprint

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Background Response of cervical cancer patients to neoadjuvant therapy differs from person to person. It remains unclear whether genetic alterations can predict response to neoadjuvant therapy and disease-free survival in cervical cancer.Methods 62 Chinese patients with stage IB-IIA cervical cancer were included in this study. Pre-treatment tumor tissues were profiled using a targeted next-generation sequencing assay. Genetic alterations were compared with those identified in the Western populations using the TCGA database. Pathological response and disease-free survival (DFS) were evaluated and their correlations with genetic alterations were analyzed.Results Genetic alterations in PIK3CA were prevalent in both Chinese and Caucasian populations. The mutation frequencies of TERT, POLD1, NOS2, and FGFR3 were significantly higher in Chinese patients whereas RPTOR, EGFR, and TP53 were frequently mutated in Caucasian patients. Germline mutations were identified in 13 out of 62 Chinese patients and 57% of them occurred in DNA repair genes, such as BRCA1/2, TP53 and PALB2. High tumor mutation burden (TMB), TP53 polymorphism (rs1042522) and KEAP1 mutations were found to be associated with poor response to neoadjuvant therapy. KEAP1 mutations, PIK3CA-SOX2 co-amplification, TERC amplification and TYMS polymorphism were associated with higher relapse rates of cervical cancer.Conclusion The similarity and difference of mutation landscape of Chinese and Caucasian patients suggested genetic background played a role in shaping the architecture of cervical cancer mutations. The associations of mutation feature of cervical cancer with patient response and tumor recurrence risk provided rationale to further validate and explore potential biomarkers for cervical cancer patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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WITHDRAWN: Multimodal genetic features correlate with poor response to neoadjuvant chemoradiotherapy and high recurrence risk in Chinese patients with stage IB-IIA cervical cancer

Wei

Chen

et al. 2020

Preprint

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“…3c, d). However, in several retrospective studies, neoadjuvant brachytherapy and chemotherapy followed by RS for stage IB2 and IIA cervical cancer patients had no obvious inferiority to NACT + RS [31,32]. Additionally, Vízkeleti et al observed that the postoperative response rate in patients who received preoperative intrauterine brachytherapy was higher than that in patients who received RS alone (P = 0.03), and the rate of positive surgical margins was significantly lower (P = 0.02) [33].…”

Section: Discussionmentioning

confidence: 99%

Comparison of survival outcomes of neoadjuvant therapy and direct surgery in IB2/IIA2 cervical adenocarcinoma: a retrospective study

Ouyang

Cai

Gui

et al. 2020

Arch Gynecol Obstet

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Purpose This retrospective study compared the efficacy and survival of patients with cervical adenocarcinoma (IB2/IIA2; FIGO2009) treated with neoadjuvant chemotherapy before radical surgery (NACT + RS), neoadjuvant chemoradiation therapy before radical surgery (NACRT + RS), or primary radical surgery (RS). Methods Between January 2008 and November 2015, 91 patients diagnosed with stage IB2/IIA2 cervical adenocarcinoma were enrolled, including 29 patients who received RS, 24 patients who received NACT + RS, and 38 patients who received NACRT + RS. Results The characteristics of patients were balanced among the three groups, and the median follow-up time was 72 months. The 5 year disease-free survival (DFS) rate was 75.8% and the 5 year overall survival (OS) rate was 85.0%. Univariate analysis revealed that effectiveness of neoadjuvant treatment, tumor size, lymph node metastases, and depth of stromal invasion were the factors predicting recurrence and mortality. Multivariate Cox proportional analysis revealed that the occurrence of a lymph node metastasis was an independent prognostic factor of DFS (hazard ratio [HR] = 0.223; 95% confidence interval [CI]: 0.060-0.827) and OS (HR = 0.088; 95% CI: 0.017-0.470). On survival analysis of preoperative adjuvant chemotherapy and primary surgery, the 5 year OS (P = 0.010) and DFS (P = 0.016) rates for the NACRT + RS group were significantly lower than those for the RS group. Conclusion Stage IB2/IIA2 cervical adenocarcinoma patients who received primary RS had a better DFS and OS than those who received preoperative NACRT. There was no significant difference when compared to the preoperative NACT group.

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“…Currently, this assessment is based mainly on the clinical and pathological characteristics of cervical cancer, such as age, stage, tumor size, histological type and depth of tumor invasion, positive surgical margins, the presence of metastases in the lymph nodes, the presence of parametric and perineural invasion, and some other factors [37][38][39][40]. Despite careful selection, in some patients, adjuvant therapy is not only ineffective but also leads to the development of severe complications [9,10,12,13,[41][42][43][44]. In this regard, the problem of selecting patients with a low risk of disease recurrence, as well as with chemo-and radioresistant tumors, remains relevant and the search for new prognostic and predictive markers of cervical cancer has not lost its significance.…”

Section: Discussionmentioning

confidence: 99%

Morphological Characteristics and Clinical Significance of Different Types of Tumor Vessels in Patients with Stages I-IIA of Squamous Cervical Cancer

Сеньчукова

Макарова

Shurygina

et al. 2020

Journal of Oncology

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The determination of factors associated with progression of cervical cancer is important, both for a recurrence risk assessment and for determining optimal treatment tactics. Previously, we showed the prognostic value of different types of tumor microvessels (MVs) in gastric and breast cancer. The object of this research was to study the morphology and clinical significance of different tumor microvessels in early cervical cancer. A total of 65 archived paraffin blocks of patients with I-IIA stages of squamous cervical cancer were investigated. Samples were stained with Mayer hematoxylin and immunohistochemically using antibodies to CD34, podoplanin, HIF-1a, and Snail. The eight types of tumor MVs differed in morphology were identified. It was established that only the dilated capillaries (DСs) with weak expression of CD34, the contact type DCs, the capillaries in tumor solid component, and the lymphatic vessels in the lymphoid and polymorphic cell infiltrates of tumor stroma are associated with clinical and pathological characteristics of early cervical cancer. Preliminary results also suggest that a combination of fragmentation in tumor solid component and the contact type DCs may predict a recurrence of early cervical cancer. Given the small number of cervical cancer recurrences, the predictive significance of the described markers requires a more thorough examination.

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Neoadjuvant brachytherapy and chemotherapy followed by radical surgery in stage IB2 and IIA cervical cancer: A retrospective comparison with chemoirradiation

Cited by 4 publications

References 26 publications

WITHDRAWN: Multimodal genetic features correlate with poor response to neoadjuvant chemoradiotherapy and high recurrence risk in Chinese patients with stage IB-IIA cervical cancer

WITHDRAWN: Multimodal genetic features correlate with poor response to neoadjuvant chemoradiotherapy and high recurrence risk in Chinese patients with stage IB-IIA cervical cancer

Comparison of survival outcomes of neoadjuvant therapy and direct surgery in IB2/IIA2 cervical adenocarcinoma: a retrospective study

Morphological Characteristics and Clinical Significance of Different Types of Tumor Vessels in Patients with Stages I-IIA of Squamous Cervical Cancer

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