Survival and Prognostic Factors in Patients with Carcinoma of Cervical Stump

Abstract

Purpose: To evaluate patients with carcinoma of cervical stump (CCS) and analyse different clinico-pathologic factors affect prognosis. Patients and Methods: This study was carried out through review of clinical records of patients. Recorded data included information on age, tumor stage, presenting symptoms, size of tumor, histopathology, grade, type, cause of subtotal hysterectomy (STH), treatment and follow-up results. Staging according to International Federation of Gynecology and Obstetrics (FIGO) staging system was done through: PHYSICAL examination, pelvic examination under anaesthesia, chest X-ray, magnetic resonance imaging (MRI) of the abdomen and pelvis, cystoscopy, rectosigmoidoscopy and intravenous pyelography. Prognostic factors as age, size of tumor, stage, lymph node (LN) involvement, pathological type, grade and type of CCS either true or coincidental were analysed through multivariate analysis. Results: 62% of patients are above 50 years with stage II in 48.7%. Squamous cell carcinoma was more common but 54% are of GIII. 89% were true CCS. Positive lymph nodes were reported in 27%. The predominant reason for STH was abnormal bleeding (73%). In about 95% of cases, women seeked medical attention because of symptoms and the most common presenting symptom was bleeding (54%). According to the stage and performance status of patients, treatment consisted of radiotherapy either external or interstitial, chemotherapy and chemoradiotherapy. Through multivariate analysis, the following was found to have adverse impact on survival: Coincidental type (P = 0.04), high grade (P = 0.03), advanced stage (P = 0.01), larger tumor size (P = 0.02), lymph node involvement (P = 0.029) and older age (P = 0.035). While pathological type was not (P = 0.52). After median follow-up of 52 months; 5-year overall survival was 65%. Conclusion: CCS has a low morbidity. Adverse survival outcomes can be anticipated in those patients with: high grade lesions, advanced stages, large tumor size, coincidental type, older age and positive lymph node involvement. H. A. Wahba et al.

Towards identifying the mode of action of drugs using live-cell FTIR spectroscopy

“…58,59 Doxorubicin is a DNA alkylator which is used in the treatment of triple negative breast cancer and its activity against MDA MB 231 is well documented. 60,61 Figure 3A shows an example of the MTT assay result for the MDA-MB-231 cells treated with (1-100 µM) of tamoxifen for 24 hours is shown and the IC50 was found to be at ~25 µM (refer to Table 1). When exposing the attached live MDA-MB-231 cells on the ATR element to this concentration, where a 50% decrease in cell is expected, Figure 3B shows an approximately 37% decrease in amide II absorbance relative to the control.…”

Supravaginal hysterectomy in Curaçao prevalence and impact on screening for cervical cancer

“…However given the prevalence of an intact cervix after hysterectomy (2.9%) and the published risk of cervical carcinoma in the cervical stump (3–9% of cervical cancer cases in the world) ( Hellström et al, 2001 , Hellström et al, 2011 ; Cléber et al, 2004 , Wahba et al, 2015 ) we aim to inform women still to continue with cervical screening after a supravaginal hysterectomy. This information must be clear to both, patient and health providers in charge of screening.…”

“…Cancer of the preserved cervical stump contributes to 3–9% of cervical cancer cases in the world. ( Hellström et al, 2001 , Hellström et al, 2011 , Cléber et al, 2004 , Wahba et al, 2015 ) The present study was set up with the aim to obtain insight in the proportion of supravaginal hysterectomies in women from Curaçao, and to investigate the level of awareness of the need of continuing cervical cancer screening in case of a preserved cervix.…”

Epidermal growth factor receptor targeted doxorubicin and vitexin loaded niosomes for enhanced breast cancer therapy

“…Previous reports have shown that cetuximab combined with chemotherapeutic drugs was effective in treating TNBC. 62,63 Cetuximab binds to the epidermal growth factor receptor (EGFR), which is important in metastasis, tumorigenesis, drug resistance, and cell proliferation. 62,63…”