The postoperative classification for uterine cervical cancer and its clinical evaluation

Noguchi, Hiroshi; Shiozawa, Kyuyo; Tsukamoto, Takashi; Tsukahara, Yoshiharu; Iwai, S; Fukuta, Toru

doi:10.1016/0090-8258(83)90096-3

Cited by 24 publications

(13 citation statements)

References 4 publications

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“…In previous studies, patients with endometrial extension have been shown to have a poor prognosis because of a higher rate of development of distant metastases, [2][3][4][5]18 but there was no explanation of this finding. Narayan et al has shown a correlation between magnetic resonance imaging (MRI) endometrial extension and FDG-PET-detected lymph nodes.…”

Section: Discussionmentioning

confidence: 66%

“…Therefore, we suggest that endometrial extension is correlated with lymph node metastases, which correlates with development of distant metastases and a worse prognosis. [2][3][4][5]18 In the absence of FDG-PET evaluation, evidence of endometrial extension may assist in assessing a patient-s risk of lymph node metastasis. This prognostic information may be useful in stratifying patients for risk-adjusted therapies.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] Staging systems of cervical carcinoma, including the League of Nations system, included endometrial invasion as a distinguishing criterion, 6 but this factor is not used in the current International Federation of Gynecology and Obstetrics (FIGO) staging system. Perez and colleagues showed that endometrial invasion by cervical cancer was a significant negative prognostic factor associated with a 10 -20% decrease in overall survival among irradiated patients of the same stage.…”

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confidence: 99%

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FDG‐PET in carcinoma of the uterine cervix with endometrial extension

Hope

Saha

Grigsby

2005

Cancer

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BACKGROUNDThe authors wished to determine whether pretreatment pathologic evidence of endometrial invasion correlated with fluorine‐18 fluorodeoxyglucose positron emission tomography (FDG‐PET) findings and outcomes in patients with carcinoma of the uterine cervix.METHODSPretreatment whole body FDG‐PET was performed in 58 patients with cervical carcinoma who also underwent pathologic evaluation of the endometrium by biopsy or dilation and curettage. FDG‐PET lymph node status, disease free survival, and overall survival were evaluated.RESULTSThirty seven (64%) patients had pathologic evidence of endometrial invasion. Pelvic lymph node metastases were three times more frequent in patients with evidence of endometrial invasion compared with those without endometrial invasion (70% vs. 23%, P < 0.001). Patients with endometrial invasion also had a significantly increased risk of paraaortic and supraclavicular lymph node metastases at presentation (30% vs. 0% P = 0.006). Endometrial invasion was associated with a decreased 2‐year disease‐free survival (78% vs. 58%, P = 0.046) and overall survival (92% vs. 65%, P =0.047).CONCLUSIONSEndometrial extension in cervical cancer correlated strongly with risk of FDG‐PET detected lymph node metastases in this study's population and was associated with a poor prognosis. Cancer 2006. © 2005 American Cancer Society.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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FDG‐PET in carcinoma of the uterine cervix with endometrial extension

Hope

Saha

Grigsby

2005

Cancer

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“…Reported incidences of parametrial extension in early stages varied between 7% and 16.8% [13,60,64]. There is a good correlation between parametrial extension and the incidence of lymph node metastases and recurrence [13,16,60,64,82,98]. A significant difference in 5-year survival rate has been described between patients with and without parametrial extension (Table VI).…”

Section: Parametrial Extensionmentioning

confidence: 78%

“…Pejovic et al [103], Fuller et al [47] and Kortmeier [73] described a better prognosis for patients with squamous cell carcinoma than for patients with adenocarcinoma. Others [7,13,16,30,98], however, found no cell-type dependent differences in prognosis, Swan et al [124] found a better survival rate with large non-keratinizing carcinomas compared with parvocellular carcinomas after radiotherapy, but not after surgical treatment, suggesting that parvoqllular carcinomas are less radiosensitive. In summary, it is still doubtful whether cell type is of prognostic significance.…”

Section: Histology: Cell Differentiation and Cell Typementioning

confidence: 99%

A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy

Bommel¹,

Lindert²,

Kock³

et al. 1987

European Journal of Obstetrics & Gynecology and Reproductiv

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Several prognostic factors in stages I B and II A cervical carcinoma have been widely studied to define groups of patients with a poor prognosis. Most of these factors are interrelated. The characteristics which should be regarded as main factors have not yet been defined, because the studies reported were based on mainly retrospective and non-randomized analysis. Reviewing the literature, lymph node metastasis, differentiation grade, tumor size, parametrial extension, lymphblood vessel invasion and cervical invasion seem to be prognostically important factors, which suggests that the subdivision of patients according to the FIG0 classification alone is inaccurate. It seems useful to define subgroups of patients according to tumor characteristics, determined after surgical treatment and accurate histologic examination of the surgical specimen. Patients with one or more of these tumor features need additional treatment to improve survival. The current treatment modalities, such as postoperative radiotherapy, have not been thoroughly evaluated, but doubt exists as to their efficacy. Data in the literature suggest that particularly patients with para-aortic or multiple pelvic lymph node metastasis (> 3) have already developed distant metastases at the time of primary treatment and therefore need adjuvant systemic therapy. Patients with tumors larger than 4 cm in diameter, differentiation grade III, lymph-blood vessel invasion or cervical invasion (of more than 70%) seem to have high recurrence rates at both pelvic and distant sites, indicating that there is also a need for better pelvic control.

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Thickness of uninvolved fibromuscular stroma and extrauterine spread of carcinoma of the uterine cervix

Kishi

Hashimoto

Sakamoto

et al. 1987

Cancer

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The minimum thickness of cervical fibromuscular stroma remaining uninvolved with invasive cervical carcinoma was examined in relation to pelvic node metastases and 5-year cancer death rate, using specimens from Stage IB, IIA, and IIB patients who underwent radical hysterectomy and pelvic lym-phadenectomy. The nodal metastasis and 5-year cancer death rates were 7% and 8%, respectively, in patients with the uninvolved fibromuscular stroma thickness above 3 mm, and 37% and 26%, respectively , in patients with the thickness below 3 mm. The thickness of cancer-unaffected cervical fibro-muscular stroma seemed to be closely related to and to be a more useful parameter of the biological behavior of invasive cervical carcinoma than the depth of the cancer invasion. A threshold value of the minimum thickness of the tissue as a barrier against extrauterine spread of cervical cancer could not be identified in this study.

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The postoperative classification for uterine cervical cancer and its clinical evaluation

Cited by 24 publications

References 4 publications

FDG‐PET in carcinoma of the uterine cervix with endometrial extension

FDG‐PET in carcinoma of the uterine cervix with endometrial extension

A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy

Thickness of uninvolved fibromuscular stroma and extrauterine spread of carcinoma of the uterine cervix

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