Surgical Treatment of Early-Stage Cervical Cancer: A Multi-Institution Experience in 2124 Cases in The Netherlands Over a 30-Year Period

Derks, Marloes; Velden, J. van der; Kroon, Cornelis D. de; Nijman, Hans W.; Lonkhuijzen, Luc van; Zee, Ate G.J. van der; Zwinderman, Aeilko H.; Kenter, Gemma G.

doi:10.1097/igc.0000000000001228

Cited by 42 publications

(36 citation statements)

References 39 publications

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“…This is in contrast with the data of the study of Cibula et al, where a type C2 radical hysterectomy was performed in tumors that were >4 cm in diameter, resulting in an isolated local recurrence rate of 1.6% 4. In a recent, large retrospective study, we have shown that radicality of surgery is an independent prognostic factor for recurrence and survival, especially in the group of patients with large tumors (>4 cm) 18. Therefore, we hypothesize that also the relatively low isolated loco-regional recurrence rate of 5.6% in our study population is the result of more radical surgery.…”

Section: Discussioncontrasting

confidence: 86%

Analysis of isolated loco-regional recurrence rate in intermediate risk early cervical cancer after a type C2 radical hysterectomy without adjuvant radiotherapy

Velden

Mom

Lonkhuijzen

et al. 2019

Int J Gynecol Cancer

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BackgroundThe efficacy of adjuvant radiotherapy in patients with intermediate risk early cervical cancer after radical hysterectomy is still under debate. Most guidelines recommend adjuvant radiotherapy, whereas others consider observation a viable option.ObjectiveTo investigate if patients with intermediate risk factors for cervical cancer who underwent radical hysterectomy may benefit from adjuvant radiotherapy.MethodsConsecutive patients with tumor confined to the cervix and intermediate risk factors (according to Sedlis), treated between January 1982 and December 2014 who were observed after a type C2 radical hysterectomy formed the basis for this study. The frequency of recurrences, specifically isolated loco-regional recurrences, and the risk of death from recurrences, were analyzed. Data were analyzed using SPSS, version 23.0 for WindowsResultsA total of 161 patients were included in the analysis. Median age was 40 (range 20–76). Stages IB1 and IB2 were seen in 87 (54%) and 74 patients (46%), respectively. Squamous cell and non-squamous histology was seen in 114 (70.8%) and 47 patients (29.2%), respectively. Of the 161 patients, 25 (15.5%) had recurrent disease, of whom nine had an isolated loco-regional recurrence (5.6%). Median time to recurrence for isolated loco-regional recurrences was 28 months (range 9–151). Treatment for an isolated loco-regional recurrence was radiotherapy (n = 4) and chemoradiotherapy (n = 5). Four patients (2.5%) died from disease as a result of an isolated loco-regional recurrence. Actuarial disease- specific survival was 93.0% for the total group. No variables were found that predicted an isolated loco-regional recurrence.DiscussionThe mortality from isolated loco-regional recurrence in patients with intermediate risk factors for cervical cancer who underwent only radical hysterectomy type C2 was 2.5%. Further studies should compare outcomes between patients who undergo a type C2 radical hysterectomy without adjuvant radiotherapy with those undergoing a less radical hysterectomy but with adjuvant radiotherapy.

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Section: Discussioncontrasting

confidence: 86%

Analysis of isolated loco-regional recurrence rate in intermediate risk early cervical cancer after a type C2 radical hysterectomy without adjuvant radiotherapy

Velden

Mom

Lonkhuijzen

et al. 2019

Int J Gynecol Cancer

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“…Previous studies have revealed that DSI was not only closely related to cervical cancer recurrence, but also an independent factor for poor survival 3 , 8 . Our findings were in accord with their results that depth of stromal invasion was an independently prognostic factor for both DFS and OS.…”

Section: Discussionmentioning

confidence: 97%

“…Some factors were identified before the operation, such as the palpable tumor volume and extension. After surgery, some important pathological variables were classified as the intermediate and high risk factors, such as tumor volume, lymphovascular space invasion (LVSI), deep stromal invasion (DSI), lymph node metastases, parametrial infiltration, surgical margin and/or positive parametrium, and warranted necessary adjuvant therapy 6 - 8 . However, even if some pathological variables were proved to have impact on survival, they are not incorporated in the staging system.…”

Section: Introductionmentioning

confidence: 99%

The clinical and prognostic implication of deep stromal invasion in cervical cancer patients undergoing radical hysterectomy

Zhu¹,

Cao²,

Wen³

et al. 2020

J. Cancer

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Background: To evaluate the patterns of recurrence and survival related to deep stromal invasion (DSI) in cervical cancer patients who underwent the radical surgery. Methods: Patients with International Federation of Gynaecology and Obstetrics (FIGO) 2009 stage IB and IIA and definite pathology-confirmed deep stromal invasion between 03/2006 and 06/2014 were collected. A subcategorization of deep stromal invasion (inner full-thickness, full-thickness and outer full-thickness) were performed. Disease-free survival (DFS) and overall survival (OS) were compared by Kaplan-Meier analysis and independent predictors were identified using Cox regression analysis. Results: A total of 3,298 cervical cancer patients were included. The proportion of patients with outer 1/3 to full-thickness invasion, full-thickness invasion and outer-full-thickness invasion were 60.6%, 33.5% and 5.9%, respectively. Deep stromal invasion strongly correlated with patients' age, stage, menopause status, tumor diameter, lymphovascular space invasion (LVSI), nodal metastasis, parametrial and vaginal involvement, as well as the site of recurrence. However, no connection was found between the DSI and tumor histologic type. Upon further analysis, patients with full- and outer-full-thickness invasion exhibited significantly higher recurrence rates compared to inner full-thickness group. Both DFS and OS was independently associated with the depth of deep stromal invasion. By subgroup analysis, multivariate analysis revealed that only adjuvant radiotherapy was independent risk factors for both DFS and OS in isolated full-thickness invasion patients. Conclusions: This study indicated that the depth of deep stromal invasion is an important prognostic factor in patients with cervical cancer. Patients with full-thickness invasion should receive customized adjuvant treatment.

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“…2 At present, the treatment of cervical cancer involves surgical resection and radiation therapy as well as chemotherapy. 3 The considerable progress in the diagnosis and treatment has significantly improved the clinical outcomes of patients with cervical cancer; however, many patients receive the diagnosis at advanced stages, and the prognosis of these patients remains unsatisfactory, with a 5-year survival rate of less than 40%. 4,5 Furthermore, the molecular pathogenesis of cervical cancer is complicated and needs to be elucidated further.…”

Section: Introductionmentioning

confidence: 99%

<p>Long Noncoding RNA SNHG7, a Molecular Sponge for microRNA-485, Promotes the Aggressive Behavior of Cervical Cancer by Regulating PAK4</p>

Wu¹,

Sui²,

Wang³

et al. 2020

OTT

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Purpose: A long noncoding RNA called small nucleolar RNA host gene 7 (SNHG7) is known to be a key regulator of biological processes in multiple human cancer types. In this study, our aims were to determine the expression status of SNHG7 in cervical cancer, to figure out the detailed roles of SNHG7 in cervical cancer cells, and to identify the mechanism underlying the activity of SNHG7 in cervical cancer. Methods: Reverse-transcription quantitative PCR was performed to measure SNHG7 expression in cervical cancer. A Cell Counting Kit-8 assay, flow-cytometric analysis, cell migration and invasion assays, and a tumor xenograft experiment were conducted to respectively determine the effects of SNHG7 on cervical cancer cell proliferation, apoptosis, migration, and invasion in vitro and tumor growth in vivo. Results: SNHG7 was found to be markedly upregulated in cervical cancer tissues and cell lines. Higher SNHG7 expression significantly correlated with FIGO stage, lymph node metastasis, the depth of cervical invasion, and shorter overall survival in patients with cervical cancer. Functional experiments indicated that a SNHG7 knockdown attenuated proliferation, migration, and invasiveness and promoted apoptosis of cervical cancer cells in vitro. The SNHG7 knockdown also slowed tumor growth in vivo. Further investigation showed that SNHG7 acts as a competing endogenous RNA for microRNA-485 (miR-485) in cervical cancer cells, and the inhibitory actions of the SNHG7 knockdown on the malignant phenotype were reversed by miR-485 inhibition. P21-activated kinase 4 (PAK4) was identified as a direct target gene of miR-485 in cervical cancer, and PAK4 expression was promoted by SNHG7. Conclusion: SNHG7 functions as an oncogenic RNA in cervical cancer, competitively binds to miR-485, and thereby upregulates PAK4. This SNHG7-miR-485-PAK4 regulatory network may provide insights into the pathogenesis of cervical cancer, and can help in the identification of novel diagnostic and therapeutic approaches for cervical cancer.

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Surgical Treatment of Early-Stage Cervical Cancer: A Multi-Institution Experience in 2124 Cases in The Netherlands Over a 30-Year Period

Cited by 42 publications

References 39 publications

Analysis of isolated loco-regional recurrence rate in intermediate risk early cervical cancer after a type C2 radical hysterectomy without adjuvant radiotherapy

Analysis of isolated loco-regional recurrence rate in intermediate risk early cervical cancer after a type C2 radical hysterectomy without adjuvant radiotherapy

The clinical and prognostic implication of deep stromal invasion in cervical cancer patients undergoing radical hysterectomy

<p>Long Noncoding RNA SNHG7, a Molecular Sponge for microRNA-485, Promotes the Aggressive Behavior of Cervical Cancer by Regulating PAK4</p>

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