Prognostic factors affecting survival and recurrence in patients with early cervical squamous cell cancer following radical hysterectomy

Li, Dan; Xu, Ximing; Yan, Dingding; Yuan, Shengguang; Ni, Juan; Lou, Hanyi

doi:10.1177/0300060519889741

Cited by 10 publications

(12 citation statements)

References 28 publications

(36 reference statements)

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“…The number of MLN is associated with survival. The patients with >2 MLNs had a significantly lower rate of DFS and OS, compared to those with 1-2 MLNs [4,6]. Our result showed a similar trend.…”

Section: Discussionsupporting

confidence: 81%

“…The standard treatment of early-stage cervical cancer is radical hysterectomy with pelvic lymphadenectomy (RHPL) [3]. The adjuvant treatments are considered for the patient with some post-operative factors including lymph node status, surgical margin, lymph vascular space invasion (LVSI), stromal invasion and tumor size [3][4][5][6]. Many studies re-ported that lymph node metastasis is an important prognostic factor affecting survival outcomes [5,7].…”

Section: Introductionmentioning

confidence: 99%

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Number of lymph node in early-stage cervical cancer after radical surgery, does it matter?

Innao¹,

Benjakul²,

Chaowawanit³

2021

European Journal of Gynaecological Oncology

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To determine the number of lymph nodes obtained from radical hysterectomy with pelvic lymphadenectomy (RHPL) and survival rates of the early-stage cervical cancer patients with various numbers of removed lymph nodes (RLNs) and metastatic lymph nodes (MLNs). Materials and methods: 407 patients with early-stage cervical cancers who underwent RHPL were included in this study. We reviewed all medical records from January 2005-June 2020 and excluded the patients who had incomplete medical record, loss of follow-up visits and received neo-adjuvant chemotherapy. Results: Three-hundred-and-fifty-four patients were analyzed. The median time of follow-up was 44.3 months, the average number of RLNs was 23 (range 7-29) and 91.7% of our cases had >12 RLNs. MLNs were found in 36 cases (10.2%). The patients with RLNs <12 had a significantly lower 5-year cancer-specific survival (CSS) compared to those with RLNs >12 (73.6 % and 97.0%, respectively, p-value < 0.001) but 5-year progression-free survival (PFS) was not different between both groups. Based on lymph node status, the 5-year PFS and CSS of node-negative vs. node-positive patients were 99.3% vs. 76.2% and 97.5% vs. 74.0%, respectively. Conclusion: An extensive lymphadenectomy had a survival benefit in early-stage cervical cancer patients. The patients with RLNs >12 had better 5-year CSS. MLNs and RLNs <12 are significant prognostic factors for PFS and CSS.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Number of lymph node in early-stage cervical cancer after radical surgery, does it matter?

Innao¹,

Benjakul²,

Chaowawanit³

2021

European Journal of Gynaecological Oncology

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“…7 Many factors affect the prognosis of cervical cancer, such as parametrial involvement, tumor size, LNM, surgical margin, tumor invasion depth, differentiation grade, and LVSI. 21 Compared with FIGO 2009, another major change in the 2018 staging is the addition of stage IIIC, based on LNM, which is based on the theory that LNM can affect prognosis and which is supported by several studies and by our results. 22,23 In one study, the 5-year OS of patients with SCC was 88% in the non-LNM group compared with 57% in the LNM group.…”

Section: Discussionsupporting

confidence: 75%

“…Many factors affect the prognosis of cervical cancer, such as parametrial involvement, tumor size, LNM, surgical margin, tumor invasion depth, differentiation grade, and LVSI. 21 The National Comprehensive Cancer Network (NCCN) guidelines classify these factors into high-risk (LNM, surgical margin, parametrial involvement) and medium-risk (LVSI, tumor invasion depth, and tumor size) groups. Compared with FIGO 2009, FIGO 2018 was associated with more prognostic factors in this study, including two medium-risk factors: tumor invasion depth and LVSI, consequently leading to a more accurate prediction of patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

Data from small cell neuroendocrine carcinoma of the cervix: FIGO 2018 staging is more accurate than FIGO 2009

2022

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Objective To compare the prognostic value of International Federation of Gynecology and Obstetrics (FIGO) 2009 and 2018 staging systems in surgical patients with small cell neuroendocrine carcinoma of the cervix (SCNEC). Methods We re-staged 64 surgical IB–IIA (FIGO 2009) SCNEC patients according to the FIGO 2018 system and refined stage IIIC of FIGO 2018 based on tumor local invasion. The prognostic factors were analyzed, and the advantages of FIGO 2018 were compared with 2009. Results The 5-year overall survival rate (OS) was 78.5% for stage I and 22.2% for stage II (FIGO 2009). In FIGO 2018, there was no difference between stage I and II, and the 5-year OS was 74.1%, 60.2%, and 0% for stage I/II, IIIC1, and IIIC2. After combining stage IIIC with the local invasion stage (T1 was limited to the cervix and vagina; T2 involved the parametrium; T3 involved the pelvic or abdominal cavity), the 5-year OS for stage IIICT1, IIICT2, and IIICT3 was 83.3%, 30.0%, and 0%, respectively. Conclusions For stage II SCNEC patients, FIGO 2009 underestimated the prognosis, while FIGO 2018 was more accurate. For stage IIIC, FIGO 2018 might be more individualized and accurate after combining stage IIIC with tumor local invasion.

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“…Tumor size is generally accepted as an independent prognostic factor [21,22]. However, the optimal time to start postoperative RT in individuals with risk factors has not been well de ned.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Versus Open Surgery for Radical Hysterectomy Followed By Adjuvant Radiotherapy in Intermediate- or High-Risk Early-Stage Cancer of The Cervix: A Retrospective Study

Zhang¹,

Li²,

Wang³

et al. 2021

Preprint

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Background Postoperative radiotherapy (RT) or chemoradiotherapy (CRT) improves outcomes of cervical cancer patients with risk factors. Minimally invasive surgery (MIS) has an inferior survival than open radical hysterectomy (ORH), however, the impact of MIS on postoperative RT remains uncertain. The study compared the impacts of MIS versus ORH on delivering of adjuvant RT or CRT for intermediate- or high-risk early-stage cervical cancer. Methods Data on stage IB1-IIA2 patients who underwent radical hysterectomy and postoperative RT/CRT in our institution, from 2014 to 2017, were retrospectively collected. Patients with high or intermediate-risk factors who met the Sedlis criteria received postoperative pelvic external beam radiotherapy (50Gy/25f) with platinum-based chemotherapy (0–6 cycles) according to guidelines. Disease-free survival (DFS) and overall survival (OS) were compared in the two surgical groups. Results One hundred and twenty-nine patients eligible for the study (68 in ORH; 61 in MIS groups) had similar clinicopathologic features except for the stage (highest in MIS was IB1; IIA1 in ORH) and presence of lymph vascular space invasion (higher in MIS group). The median time interval from surgery to chemotherapy and to RT was shorter in the MIS group. Three-year DFS and OS were similar in both groups. Further sub-analysis indicated that the DFS and OS in intermediate/high-risk groups had no significant difference. Cox-multivariate analyses found that tumor size > 4 cm and time interval from surgery to RT beyond seven weeks were adverse independent prognostic factors for DFS. Conclusions In early-stage (IB1-IIA2) cervical cancer patients with intermediate or high-risk factors who received postoperative RT or CRT, no matter they received ORH or MIS as their primary treatment, the DFS and OS had no significant difference, despite TI from surgery to postoperative adjuvant therapy being shorter in the MIS group than ORH.

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Prognostic factors affecting survival and recurrence in patients with early cervical squamous cell cancer following radical hysterectomy

Cited by 10 publications

References 28 publications

Number of lymph node in early-stage cervical cancer after radical surgery, does it matter?

Number of lymph node in early-stage cervical cancer after radical surgery, does it matter?

Data from small cell neuroendocrine carcinoma of the cervix: FIGO 2018 staging is more accurate than FIGO 2009

Minimally Invasive Versus Open Surgery for Radical Hysterectomy Followed By Adjuvant Radiotherapy in Intermediate- or High-Risk Early-Stage Cancer of The Cervix: A Retrospective Study

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