Prognostic Factors in Surgically Treated Stage Ib–IIb Cervical Carcinomas with Special Emphasis on the Importance of Tumor Volume

Trattner, Maria; Graf, Anton-H.; Lax, Sigurd; Forstner, Rosemarie; Dandachi, Nadia; Haas, Josef; Pickel, H; Reich, Olaf; Staudach, A.; Winter, Raimund

doi:10.1006/gyno.2001.6252

Cited by 76 publications

(55 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lymph node metastasis was an independent prognostic factor (11)(12)(13)(14)(15)(16)(17). However, in a univariate analysis of patients with positive lymph nodes, Rutledge et al reported that 2-year DFS decreases from 89% to 63%, whereas a (19).…”

Section: Discussionmentioning

confidence: 99%

Does lymph node involvement affect the patterns of recurrence in stage IB cervical cancer?

Üreyen¹,

Aksoy²,

Dündar³

et al. 2014

Turk J Med Sci

View full text Add to dashboard Cite

IntroductionCarcinoma of the cervix uteri is the second most common cancer and the third most common cause of cancer deaths in women worldwide (1,2). The definitive primary treatment for patients with early-stage disease consists of radiation therapy or radical hysterectomy with pelvic and/ or paraaortic lymph node dissection (3). Knowledge about prognosis and recurrence is critical for the management of early-stage cervical cancer. Lymph node involvement is an important risk factor for recurrence in patients with earlystage cervical cancer. The recurrence rate in lymph nodenegative patients was 10% and the 5-year survival rate ranged from 85%-90%. In contrast, the recurrence rate in lymph node-positive patients was 27% and the 5-year survival rate ranged from 20% to 74% depending on the number of nodes that were involved and the location and size of the metastases (4-6).In this retrospective study, we analyzed the variations in the recurrence patterns of stage IB cervical cancer according to lymph node involvement. These data may improve the management of early-stage cervical cancer to reduce the risk of recurrence and predict the recurrence patterns of early-stage cervical cancer. Materials and methodsThe medical records of patients diagnosed with stage IB cervical cancer and who were treated with type III radical hysterectomy, bilateral salpingo-oophorectomy, or systemic pelvic and paraaortic lymphadenectomy from January 1993 to December 2007 were evaluated retrospectively. The complete pathological data of 170 patients were evaluated. Patients who received neoadjuvant chemotherapy were excluded because chemotherapy is known to improve surgical pathological results (7).All of the patients were evaluated by rectovaginal examination under general anesthesia, computerized tomography of the upper abdomen and pelvic magnetic resonance imaging, or intravenous pyelography. Clinical Background/aim: To investigate the variations in the recurrence patterns of stage IB cervical cancer according to lymph node involvement. Materials and methods:We reviewed the medical records of 170 patients who had undergone type III radical hysterectomy and systematic lymphadenectomy from 1993 to 2007.Results: Among the patients in the study group, 115 did not have lymph node metastases, whereas 55 did. A total of 27 patients developed recurrences. Twelve were in the lymph node-negative group, and 15 were in the lymph node-positive group. The recurrence rate was higher in lymph node-positive group (27.3% versus 10.4%, P = 0.011). The recurrence pattern was not affected by lymph node involvement. However, distant recurrence was more common in the lymph node-positive group (53.3% versus 25%, P = 0.137). Additionally, distant failure was observed only in the patients in the lymph node-negative group who received adjuvant radiotherapy. In this group, 3 patients who did not receive adjuvant radiotherapy developed recurrences only in the pelvic region. Conclusion:The presence of lymph node involvement in stage IB cervical cancer does not affec...

show abstract

Section: Discussionmentioning

confidence: 99%

Does lymph node involvement affect the patterns of recurrence in stage IB cervical cancer?

Üreyen¹,

Aksoy²,

Dündar³

et al. 2014

Turk J Med Sci

View full text Add to dashboard Cite

show abstract

“…Tumor size has been suggested as an important prognostic factor in patients with cervical cancer. [7][8][9][10][11] Although there are several diagnostic methods including pelvic examination, intra-venous pyelogram, cystoscopy, proctoscopy and others, pelvic examination is the only single method for evaluating the size, location and parametrial invasion of the cervical mass. Thus, exact pelvic examination is important for the management of patients with cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

Value of pelvic examination and imaging modality for the evaluation of tumor size in cervical cancer

et al. 2008

View full text Add to dashboard Cite

Objective: The purpose of this study was to compare the accuracy of pelvic examination versus imaging modality such as computed tomography (CT) or magnetic resonance imaging (MRI) in the measurement of the tumor size of invasive cervical carcinoma based on pathologic findings. Methods: Patients with stage Ib-II cervical cancer who underwent primary surgical treatment between January 2003 and December 2005 were evaluated retrospectively. One hundred three consecutive patients aged 24 to 81 years (mean age, 50.6 years), who had not received any treatment previously were included in this study. Accuracy of preoperative CT or MRI versus pelvic examination in the measurement of tumor size was compared based on pathologic findings. All patients were examined and staged clinically by the gynecologic oncologist. Surgery was performed within 2 weeks after imaging studies. The data were analyzed using descriptive statistics. Results: The largest diameter of the tumor measured by pathologic findings was 2.76±1.76 cm. Based on pathologic findings, accuracy was estimated by the degree of agreement with a difference of ＜0.5 or 1.0 cm between the measurements of tumor size obtained by pelvic examination and imaging modality. Pelvic examination and imaging modality had an accuracy of 46.6% and 39.8%, respectively, with a difference of ＜0.5 cm, and an accuracy of 72.8% and 55.3%, respectively, with a difference of ＜1.0 cm. Correlation with pathologic findings was higher for pelvic examination (rs=0.680) than for imaging modality (rs=0.410). In determining the size of tumor mass differentiating ＞4.0 cm from ≤4.0 cm, imaging modality showed higher accuracy than pelvic examination. Conclusion: For the patients with stage Ib to II cervical cancer, pelvic examination is superior to imaging modality with regard to evaluation of the tumor size. However, imaging modality may be accurate for evaluating bulky tumors of cervical cancer.

show abstract

Section: Tratamentul Cancerului De Col Uterin Clinic Evidentunclassified

“…Trattner și colab. într-un studiu asemănător, din 2001, constată o supraviețuire postoperatorie la 5 ani de 90% pentru pacientele aflate în stadiul IB1 comparativ cu stadiul IB2 unde supraviețuirea este de numai 40% [6].În acest context, stabilirea unei terapii ideale pentru cancerul de col uterin aflat în stadiul IB1 ca și în cel aflat în stadiul IIA rămâne controversată datorită în special, numărului limitat de studii randomizate efectuate în acest sens. …”

unclassified

Modalități Diverse de Tratament în Cancerul de Col Uterin Clinic Evident (Stadiile I B și II A)

2014

J de Chirurgie

View full text Add to dashboard Cite

This paper aims to update certain aspects of the therapeutic attitude on cervical cancer, a disease that currently is, worldwide, the second leading cause of cancer death in women and thus has increasingly come to the attention of general surgeons. The obvious clinical forms of cervical cancer are brought into discussion, meaning those in the FIGO IB1, IB2 and IIA stages, these being, by far, the most numerous cases we meet in the clinic. Unlike early cervical neoplastic lesions (stages 0 and IA) where the therapeutic attitude is relatively well codified and uniform, in obvious clinical forms there is a great variability of therapeutic approaches, with results that are close to those from the studied literature, indicating according to various statistics a survival rate at 5 years of 80% and 90% for stage I disease and between 60% and 80% for stage II patients.Keywords: Cervical Uterin Cancer; Radical Hysterectomy; Radiotherapy; Chemotherapy IntroducereCancerul de col uterin continuă să reprezinte o problemă de sănătate, peste tot în lume fiind a doua mare cauza de deces prin cancer în rândul femeilor cu peste 500.000 de cazuri noi diagnosticate anual și cu o rată a mortalității de aproximativ 50% [1]. Dintre cazurile noi diagnosticate, aproximativ 79% apar în țările în curs de dezvoltare în timp ce în Statele Unite, cancerul de col uterin este a șasea leziune malignă, ca frecvență, în rândul femeilor cu 12.900 noi cazuri diagnosticate pe an și cu aproximativ 4.400 decese anual [1].Aceste discrepanțe se explică prin diferențele privind implementarea programelor de prevenție a cancerului de col uterin, mult mai ferme în țările dezvoltate.În aceste țări, citologia cervicală reprezintă un foarte bun instrument de screening pentru leziunile pre-invazive, pe când în țările în curs de dezvoltare cele mai multe femei sunt diagnosticate cu forme invazive cu simptomatologie asociată și, în consecință, cu un prognostic mai rezervat [2]. Tratamentul cancerului de col uterin clinic evidentSpre deosebire de leziunile cervicale incipiente (stadiile 0 și IA) unde atitudinea terapeutică este relativ bine codificată și unitară, în formele clinic evidente (stadiile IB și IIA) există o mare variabilitate de abordare terapeutică, cu rezultate foarte apropiate așa cum reiese și din studiile analizate.Atât chirurgia cât și radioterapia pot fi utilizate ca primă modalitate terapeutică a cancerului de col uterin în stadiile IA și IIA, cu rezultate aparent asemănătoare.Astfel, Landoni și colab. au analizat, într-un studiu randomizat, rezultatele chirurgiei radicale versus radioterapie în stadiile IB și IIA ale cancerului cervical, negăsind diferențe semnificative nici în ceea ce privește intervalul liber de boală și nici în ceea ce privește supraviețuirea la distanță. Totuși, la 84% dintre pacientele cu tumori cervicale mari (> 4 cm), supuse intervenției chirurgicale radicale ca prim timp, li s-a efectuat radioterapie adjuvantă în condițiile existenței unor factori de risc adiționali [3]. Este recunoscut faptul că, în cazul tumo...

show abstract

Prognostic Factors in Surgically Treated Stage Ib–IIb Cervical Carcinomas with Special Emphasis on the Importance of Tumor Volume

Cited by 76 publications

References 22 publications

Does lymph node involvement affect the patterns of recurrence in stage IB cervical cancer?

Does lymph node involvement affect the patterns of recurrence in stage IB cervical cancer?

Value of pelvic examination and imaging modality for the evaluation of tumor size in cervical cancer

Modalități Diverse de Tratament în Cancerul de Col Uterin Clinic Evident (Stadiile I B și II A)

Contact Info

Product

Resources

About