Surgery for early stage cervical cancer: How radical should it be?

Reade, Clare J.; Eiriksson, Lua; Covens, Allan

doi:10.1016/j.ygyno.2013.07.078

Cited by 66 publications

(55 citation statements)

References 99 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Zhang et al [20] reported that the correlation with postoperative measurement of tumor size was higher with magnetic resonance imaging (MRI) than with a pelvic examination. Therefore, MRI can play an important role in delineating the size of tumors which extend into the endocervical canal, and may provide a more accurate assessment of tumor size when selecting patients for less radical surgery [13,20,21]. …”

Section: Discussionmentioning

confidence: 99%

“…Assessment of this as a risk factor, of course, requires knowing the pelvic lymph node status, and sentinel lymph node (SLN) biopsy has been extensively described for the assessment of the pelvic lymph nodes in cervical cancer. The sensitivity of SLN biopsy in early-stage cervical cancer is high, especially in small tumors, when using the combined technique of technetium-99 radiotracer and blue dye [21,28]. However, accurate SLN analysis requires coordinated efforts by a multidisciplinary team [6].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery

Jiamset

Hanprasertpong²

2016

Oncol Res Treat

View full text Add to dashboard Cite

Background: The aim of this study was to determine risk factors associated with parametrial involvement (PI) and to identify the subgroup of patients at low risk for PI. Methods: The study comprised 565 patients with early-stage cervical cancer, who underwent radical hysterectomy with pelvic node dissection at Songklanagarind Hospital between 1987 and 2011. Analysis was performed to determine factors associated with PI. Results: Overall, 24 (4.25%) women had PI. PI was more common in patients with non-squamous cell carcinoma, deep stromal invasion (DSI), tumor size > 2 cm, lymphovascular space invasion (LVSI), and pelvic node involvement. Multivariate analysis showed that DSI (p < 0.001) and tumor size > 2 cm (p < 0.001) were independently associated with PI. PI was linked with decreased recurrence-free (p < 0.001) and overall (p = 0.002) survival. Of 347 patients with tumor size ≤ 2 cm and no DSI, only 1 (0.29%) had PI. Conclusion: These findings confirm that PI in early-stage cervical cancer is uncommon. Risk factors associated with PI were DSI and tumor size > 2 cm. PI is a predictor of cervical cancer recurrence and decreased survival. Less radical surgery may be considered in low-risk patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery

Jiamset

Hanprasertpong²

2016

Oncol Res Treat

View full text Add to dashboard Cite

show abstract

“…Hence, a more conservative approach may be considered in those women [6,19,20]. Pluta et al, evaluated 60 patients with FIGO stage IA1 and IB1 cervical cancer who had < 2cm tumor size and < 50% cervical stromal invasion.…”

Section: Discussionmentioning

confidence: 99%

Clinical and pathological characteristics related to parametrial involvement in clinical early-stage cervical cancer

Boyraz

Başaran²,

Salman³

et al. 2016

Ginekol Pol

View full text Add to dashboard Cite

Objectives: Since parametrial involvement is believed to be a crucial factor in the management of cervical cancer, our study was designed to investigate the clinical and pathological features which predicted parametrial involvement in patients with clinical early-stage cervical cancer. Material and methods:The study included patients with clinical early-stage cervical cancer who underwent radical hysterectomy with pelvic and para-aortic lymphadenectomy between December 2001 and August 2014, at the Hacettepe University Hospital. The clinical and pathological characteristics of the affected patients were evaluated, including age, histologic subtype, tumor size, depth of cervical stromal invasion, lympho-vascular space invasion (LVSI), and lymph node metastasis. Univariate and multivariate analyses were performed to reveal factors associated with parametrial involvement. Results:The study group consisted of 126 patients (mean age: 52.7 years; range: 29-83), including 101 (80.2%) with squamous, 19 (15.1%) with adenocarcinoma, and 6 (4.8%) with adenosquamous histological subtype of cervical cancer. Parametrial involvement and lymph node metastasis were detected in 41 (32.5%) and 46 (36.5%) women, respectively. Univariate analysis showed that deep cervical stromal invasion, LVSI, tumor size > 2 cm and lymph node metastasis were associated with parametrial involvement. Multivariate logistic regression analysis identified the independent risk factors associated with parametrial involvement as LVSI (OR 8.93, 95% CI 1.1-73.5, p = 0.042) and lymph node metastasis (OR 8.8, 95% CI 1.5-9.3, p = 0.004).Conclusions: LVSI, deep cervical stromal invasion, lymph node metastasis and tumor size are significantly associated with parametrial involvement in patients with clinical early-stage cervical cancer.

show abstract

“…Then, the 3-year survival rate was 100%, and postoperative voiding difficulty was significantly less compared with radical hysterectomy. In addition, several groups have documented good oncologic outcomes for patients with early cervical cancers treated with simple hysterectomy [16]. …”

Section: Discussionmentioning

confidence: 99%

Is It Possible to Perform Less Radical Surgery for Invasive Uterine Cervical Cancer?

Togami

Kitajima²,

Kobayashi³

et al. 2015

Gynecol Obstet Invest

View full text Add to dashboard Cite

Background/Aims: A retrospective analysis was performed to evaluate the possibility of less radical surgery for early-stage invasive uterine cervical cancer without compromising the oncological outcome. Methods: The analysis was performed on 175 patients with invasive uterine cervical cancer in FIGO stage IA2-IIB, all of whom underwent primary radical hysterectomy. Relationship of tumor size with the incidence of pathologic parametrial involvement and the pelvic lymph node metastasis were investigated. Results: Fifty-one patients had tumor size ≤2 cm and 124 had tumor size >2 cm. Patients with tumor size ≤2 cm had a significantly lower incidence of parametrial invasion (p < 0.0001), lymph node metastasis (p < 0.0001), lymph vascular space involvement (p < 0.0001) and recurrence (p = 0.0002) than patients with tumor size >2 cm. Five-year relapse-free survival rate was 98 and 73%, respectively (p = 0.0004). Conclusion: It is suggested that less radical surgery may be appropriate for some cases with tumor size <2 cm.

show abstract

Surgery for early stage cervical cancer: How radical should it be?

Cited by 66 publications

References 99 publications

Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery

Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery

Clinical and pathological characteristics related to parametrial involvement in clinical early-stage cervical cancer

Is It Possible to Perform Less Radical Surgery for Invasive Uterine Cervical Cancer?

Contact Info

Product

Resources

About