Prognostic significance of positive lymph node number in early cervical cancer

Park, Jung‐Woo; Bae, Jong Woon

doi:10.3892/mco.2016.837

Cited by 19 publications

(16 citation statements)

References 21 publications

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“…Our patients underwent pelvic lymphadenectomy for pre-brachytherapy staging to tailor the patient’s definitive treatment, as lymph node metastasis is a major prognostic factor in early cervical cancer 28. Furthermore, imaging-based staging using MRI, CT, and/or positron emission tomography coupled with CT remains inferior to surgical assessment of lymph node status 29.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of pre-operative brachytherapy followed by hysterectomy for early cervical cancer

Bataille

Escande

Tinier

et al. 2019

Int J Gynecol Cancer

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ObjectiveThe standard of care for early cervical cancer is radical hysterectomy; however, consideration of pre-operative brachytherapy has been explored. We report our experience using pre-operative brachytherapy plus Wertheim-type hysterectomy to treat early stage cervical cancer.MethodsThis single-center study evaluated consecutive patients with histologically proven node-negative early stage cervical cancer (International Federation of Gynecology and Obstetrics 2009 stage IB1–IIB) that was treated using pre-operative brachytherapy and hysterectomy. Pre-brachytherapy staging was performed using magnetic resonance imaging (MRI) and pelvic lymph node assessment was performed using lymphadenectomy. The tumor and cervical tissues were treated using brachytherapy (total dose 60 Gy) followed by Wertheim-type hysterectomy. The study included patients from January 2000 to December 2013.ResultsA total of 80 patients completed a median follow-up of 6.7 years (range 5.4–8.5). The surgical specimens revealed a pathological complete response for 61 patients (76%). Patients with incomplete responses generally had less than 1 cm residual tumor at the cervix, and only one patient had lymphovascular space involvement. The estimated 5-year rates were 88% for overall survival (95% CI 78% to 94%) and 82% for disease-free survival (95% CI 71% to 89%). Toxicities were generally mild-to-moderate, including 26 cases (33%) of grade 2 late toxicity and 10 cases (13%) of grade 3 late toxicity. Univariate analyses revealed that poor disease-free survival was associated with overweight status (≥25 kg/m2, HR 3.05, 95% CI 1.20 to 7.76, p=0.019) and MRI tumor size >3 cm (HR 3.05, 95% CI 1.23 to 7.51, p=0.016).ConclusionsPre-operative brachytherapy followed by Wertheim-type hysterectomy may be safe and effective for early stage cervical cancer, although poorer outcomes were associated with overweight status and MRI tumor size >3 cm.

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Section: Discussionmentioning

confidence: 99%

Outcomes of pre-operative brachytherapy followed by hysterectomy for early cervical cancer

Bataille

Escande

Tinier

et al. 2019

Int J Gynecol Cancer

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“…In addition, we also identified LN involvement as another strongest prognostic factor affecting OS. The value of LN involvement as an important prognostic factor for survival has been reported previously 4 , 6 , 15 , 36 - 38 , 41 , 42 . However, the prognostic role of LN involvement remains unresolved 5 , 14 , 35 , 39 , 40 , 43 .…”

Section: Resultsmentioning

confidence: 61%

Monocytosis as a prognostic factor for survival in stage IB and IIA cervical cancer

Kwon

Kim

et al. 2018

J. Cancer

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Objective: To measure hematologic parameters derived from the white blood cell (WBC) count and differential count (DC) as prognostic factors for survival in patients with stage IB and IIA cervical cancer.Methods: We retrospectively examined demographic, clinicopathologic, and laboratory parameters in a cohort of 233 patients with International Federation of Gynecology and Obstetrics stage IB and IIA cervical cancer who underwent surgical resection. We further assessed the effects of the WBC count and DC-derived hematologic parameters on progression-free survival (PFS) and overall survival (OS) after controlling for other parameters.Results: Patients were followed up for a median of 46.6 months (range, 9-142 months). The Kaplan-Meier estimates of PFS and OS at 5 years were 88.5% and 92.3%, respectively. In a multivariate analysis, we identified the absolute monocyte count (AMC) (hazard ratio [HR], 11.78; P <0.001) and tumor size (HR, 5.41; P = 0.003) as the strongest prognostic factors affecting PFS. We also identified AMC (HR, 23.29; P <0.001), tumor size, (HR, 5.27; P = 0.033), and lymph node involvement (HR, 3.90; P = 0.027) as the strongest prognostic factors affecting OS. AMC remained prognostic with respect to PFS or OS in a Cox model that controlled for the neutrophil-lymphocyte ratio or lymphocyte-monocyte ratio, although neither ratio was a significant prognostic factor for survival.Conclusions: Monocytosis and an increased tumor size were found to be independent prognostic factors affecting both PFS and OS in patients with stage IB and IIA cervical cancer.

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“…Further, no signi cant survival difference is observed between patients without metastasis and those with 1-3 metastatic lymph nodes [20]. Park and Bae reported that the 5year OS rates for patients with stage IB-IIA cervical cancer and 0, 1, and ≥2 positive metastatic lymph nodes were 91, 80, and 47%, respectively (P = 0.006) [21]. Inoue and Morita reported that the 5-year OS rates for patients with stage IB-IIB cervical cancer and 0, 1, 2-3, and ≥4 positive metastatic lymph nodes were 89, 81, 41, and 23%, respectively [22].…”

Section: Discussionmentioning

confidence: 99%

UGT1A1 polymorphism has a prognostic effect in patients with stage IB or II uterine cervical cancer and one or no metastatic pelvic nodes receiving irinotecan chemotherapy

Matsuoka¹,

Murakami

Abiko³

et al. 2020

Preprint

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Background : Uridine diphosphate glucuronosyltransferase 1 family polypeptide A1 (UGT1A1 ) is a predictive biomarker for the side-effects of irinotecan; irinotecan chemotherapy reduces the volume of tumors harboring UGT1A1 polymorphisms. We aimed to determine whether UGT1A1 polymorphisms can predict progression-free survival in patients with local cervical cancer treated with irinotecan. Methods : We retrospectively analyzed the data of 51 patients with cervical cancer treated at a single institution between 2010 and 2015. All patients were diagnosed with the 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IB1, IB2, IIA, or IIB squamous cell carcinoma, underwent radical hysterectomy, and received irinotecan chemotherapy as neoadjuvant and/or adjuvant treatment. All patients were examined for irinotecan side effects using UGT1A1 tests. Conditional inference tree and survival analyses were performed considering stage, age, UGT1A1 status, and the number of metastatic lymph nodes to determine primary factors associated with progression-free survival. Results : The tree-structured survival model determined high recurrence-risk factors related to progression-free survival. The most relevant factor was ≥2 metastatic lymph nodes (p = 0.004). The second most relevant was UGT1A1 genotype (p = 0.024). Among patients with ≤1 metastatic lymph node, those with UGT1A1 polymorphisms benefited from irinotecan chemotherapy and demonstrated significantly longer progression-free survival (p = 0.020) than those with wild-type UGT1A1 . Conclusion : Irinotecan chemotherapy has the potential to benefit patients with cervical cancer, UGT1A1 polymorphism, and ≤1 metastatic lymph nodes.

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Prognostic significance of positive lymph node number in early cervical cancer

Cited by 19 publications

References 21 publications

Outcomes of pre-operative brachytherapy followed by hysterectomy for early cervical cancer

Outcomes of pre-operative brachytherapy followed by hysterectomy for early cervical cancer

Monocytosis as a prognostic factor for survival in stage IB and IIA cervical cancer

UGT1A1 polymorphism has a prognostic effect in patients with stage IB or II uterine cervical cancer and one or no metastatic pelvic nodes receiving irinotecan chemotherapy

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