Patterns of spread of invasive cancer of the uterine cervix

Beyer, Franziska; Murphy, Arthur I.

doi:10.1002/1097-0142(196501)18:1<34::aid-cncr2820180107>3.0.co;2-l

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…The rationale of the SCLN RT for cervical cancer patients with SCLN involvement relies on the following two reasons. First, for patients with cervical cancer, the pattern of lymphatic spread appears to be stepwise from the pelvic lymph nodes to the PALNs and finally to the SCLNs [12]. Based on the patterns of lymphatic spread in cervical cancer, we considered cervix cancer with SCLN involvement as a localized disease and postulate that the aggressive therapy including CCRT may improve the outcomes if there is no evidence of tumor spread outside of the SCLN.…”

Section: Discussionmentioning

confidence: 99%

Radiation therapy with chemotherapy for patients with cervical cancer and supraclavicular lymph node involvement

Lee

et al. 2012

J Gynecol Oncol

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ObjectiveWe wanted to evaluate the outcomes of cervical cancer patients with supraclavicular lymph node (SCLN) involvement and who received radiation therapy (RT) combined with chemotherapy.MethodsFrom August 2001 to April 2009, nine cervical cancer patients with SCLN involvement were treated by RT and cisplatin-based chemotherapy. Most of the patients (8/9, 88.9%) also had a positive para-aortic lymph node (PALN). The RT field was designed to include the whole pelvis, the involved PALNs and the SCLN area. The median SCLN RT dose was 66.6 Gy (range, 60 to 70 Gy).ResultsThe median follow-up period was 61 months (range, 13 to 98 months). The 3- and 5-year overall survival rates were 66.7% and 55.6%, respectively and the 3- and 5-year progression-free survival rates were 66.7% and 44.4%, respectively. The acute hematologic toxicities according to the criteria of Radiation Therapy of Oncology Group (RTOG) were G1/2 leucopenia in 3 (33.3%), G3/4 leukopenia in 6 (66.7%), G1/2 anemia in 7 (77.8%), G3 anemia in 1 (11.1%), G2 thrombocytopenia in 2 (22.2%), and G3/4 thrombocytopenia in 2 (22.2%). Within 6 months after RT, most of the patients (5/6, 83.3%) recovered from the G3/4 leukopenia, except for 1 patient who received chemotherapy after completing RT due to subsequent bone metastasis.ConclusionFor patients with advanced cervix cancer and SCLN involvement, RT with chemotherapy as active therapy can be expected to provide favorable results, although there is an increased risk of G3/4 hematologic toxicity.

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Section: Discussionmentioning

confidence: 99%

Radiation therapy with chemotherapy for patients with cervical cancer and supraclavicular lymph node involvement

Lee

et al. 2012

J Gynecol Oncol

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“…This structure on MRI images appears to correspond to the histologic structure of the cervical and parametrial tissue. Histologically, there is a region between the fatty parametrial tissue and the dense cervical stroma termed the transitional zone or border zone 28–30 . The transitional zone is characterized by abundant blood, lymphatic vessels, and nerves.…”

Section: Discussionmentioning

confidence: 99%

“…Histologically, there is a region between the fatty parametrial tissue and the dense cervical stroma termed the transitional zone or border zone. [28][29][30] The transitional zone is characterized by abundant blood, lymphatic vessels, and nerves. Therefore, the cervical stromal ring on MRI may correspond to a histological transitional zone.…”

Section: Discussionmentioning

confidence: 99%

Patterns and predictors of site‐specific recurrence in cervical cancer after radical hysterectomy

Kato

Shimada

Kato

et al. 2022

J of Obstet and Gynaecol

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Aim This study examines patterns and predictors of site‐specific recurrence to explore the causes of local recurrence of cervical cancer. Methods Radical hysterectomy was performed in 121 patients (stage IB–IIB). Nerve‐sparing was performed whenever possible. The first recurrence in local, regional, and distant areas was examined. We investigated the possibility of nerve involvement in local recurrence, focusing on paravaginal tissues containing the pelvic plexus. We provide Supporting Information on local recurrence in the paravaginal area. Results Local recurrence was an independent event from regional or distant recurrence. Local recurrence was seen only in high‐risk patients, while regional and distant recurrences were not or less related to the risk category. The independent risk factors by logistic regression for local, regional, and distant recurrence were parametrial invasion, vaginal invasion, and lymph node metastasis, respectively. Local recurrence showed a comparable or more significant negative impact on survival than distant recurrence. Among seven patients with local recurrences, five had a recurrence in the paravagina. The rate of paravaginal recurrence was one in 76 early‐stage and four in 45 locally advanced diseases. Four sites of paravaginal recurrence occurred on the nerve‐sparing side and two on the non‐nerve‐sparing side. Supporting Information demonstrated histological evidence of perineural spread into the pelvic plexus and perineural invasion of the primary tumor. Conclusions A high percentage of local recurrences are in paravaginal tissue containing the pelvic plexus. The causal association of nerve‐sparing surgery and perineural invasion with local recurrence needs to be investigated in large prospective studies.

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“…or patients with gynecologic cancer, the pattern of lymphatic spread appears to be stepwise from the pelvic lymph nodes to the para-aortic lymph nodes (PANs) and ultimately to the supraclavicular lymph nodes (SCNs) (1)(2)(3)(4)(5)(6)(7)(8)(9)(10) . The prognosis is dismal in patients with gynecologic cancer with SCN metastases, and patients with symptoms of pain experience a decline in their quality of life.…”

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confidence: 99%

Analiza zastosowania radioterapii w leczeniu nowotworów kobiecych z przerzutami do węzłów chłonnych nadobojczykowych

Tanaka

Hayashi

et al. 2016

Curr. Gynecol. Oncol.

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The aim of this study was to retrospectively investigate the benefit of radiotherapy for supraclavicular lymph nodes by determining the characteristics and survival of patients with recurrent gynecologic cancer after definitive radiotherapy. Material and methods: We reviewed the treatment outcomes of 18 gynecologic cancer patients with supraclavicular lymph nodes metastases treated. Twelve cervical cancer patients, 4 corporeal cancer patients and 2 ovarian cancer patients were investigated. Tumor responses, adverse events and the overall survival were examined. Results: The median overall survival was 12 months. The 1-and 2-year overall survival rates were 48.6% and 9.7%, respectively. The 2-year local control rate was 75.8%. Following therapy, the symptom of pain was relieved in 2 patients (2/2), and edema and swelling were improved in 6 out of 7 symptomatic patients. Eleven asymptomatic patients did not develop any symptoms during the follow-up period. Common Terminology Criteria for Adverse Events grade 2 toxicities were found in 5 patients (2 dermatitis and 4 hematologic toxicities), and grade 3 toxicities were found in 3 patients (3 hematologic toxicities). Conclusion: Radiotherapy for supraclavicular lymph nodes is effective as palliative irradiation. The 2-year local control rate was 75.8% in patients receiving this therapy, their symptoms improved and asymptomatic patients did not become symptomatic during the follow-up period. Radiotherapy for supraclavicular lymph nodes metastases is therefore recommended for preserving the patient's life.

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Patterns of spread of invasive cancer of the uterine cervix

Cited by 8 publications

References 9 publications

Radiation therapy with chemotherapy for patients with cervical cancer and supraclavicular lymph node involvement

Radiation therapy with chemotherapy for patients with cervical cancer and supraclavicular lymph node involvement

Patterns and predictors of site‐specific recurrence in cervical cancer after radical hysterectomy

Analiza zastosowania radioterapii w leczeniu nowotworów kobiecych z przerzutami do węzłów chłonnych nadobojczykowych

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