State-of-the-Art Treatment and Novel Agents in Local and Distant Recurrences of Cervical Cancer

Abstract

Depending on the stage at initial presentation, cervical cancer will recur in 25-61% of women. Typical manifestations of recurrent cervical cancer include the central pelvis and the pelvic side walls as well as retroperitoneal lymph node basins in the pelvis and the para-aortic region, and - more rarely - supraclavicular lymph nodes. There are no typical symptoms of recurrent cervical cancer. Women with suspected recurrence after cervical cancer based on gynecological examination or organ-specific symptoms must undergo imaging studies and - if technically feasible - biopsy with histological verification, especially in cases of distant metastases, in order to rule out a second primary. Radiotherapy-naïve women should be treated with salvage radiochemotherapy with curative intention. For women with previous radiotherapy, surgery in the form of hysterectomy, local resection, or pelvic exenteration is the treatment of choice. Pelvic exenteration can lead to cure in selected patients, but at the price of a high rate of complications and significant morbidity and mortality. If complete surgical resection is not feasible or if the woman is not a candidate for surgery, chemotherapy with palliative intent should be offered. Patients with recurrent disease outside the pelvis are candidates for systemic chemotherapy. Several agents have shown to be active in this situation, either in single-agent or combination regimens. Platinum-containing regimens have a superior efficacy over non-platinum regimens and bevacizumab may be added to chemotherapy.

<p>Identification of Potential Prognostic Long Non-Coding RNA Biomarkers for Predicting Recurrence in Patients with Cervical Cancer</p>

“…Recurrent CC is almost always incurable and has no typical symptoms. 18 Considering the high mortality rate among recurrent CC patients, it is necessary to develop suitable prognosis biomarkers with the potential to predict tumor progression. The ability to predict which patients have a high risk of recurrence would empower clinicians to better patient therapy.…”

The Recurrence of Cervical Precancerous Lesion Among HIV Positive and Negative Ethiopian Women After Cryotherapy: A Retrospective Cohort Study

“…According to the 2016 State-of-the-Art Treatment and Novel Agents in Local and Distant Recurrences of Cervical Cancer report, recurrence was described as being diagnosed within 2 years of initial treatment, 19 and the percentage of pelvic recurrences fluctuates from 10 to 74%, 9 which was inclusive of the current finding. The recurrence of Cervical Intraepithelial Neoplasia following treatment occurs in at least 15% of cases even with the most effective excision and ablative treatment modalities.…”

Análise do manejo cirúrgico de pacientes com câncer cervical recidivado após radioterapia e quimioterapia.

“…The standard treatment for locally advanced lesions is chemotherapy associated with radiotherapy 4 . In this scenario, the recurrence rate varies from 15% to 30%, with a minority of these cases eligible for surgery 5,6 . Prognostic factors that decrease recurrence or increase survival rates are:…”