The prognostic significance of cell type and lesion size in patients with cervical cancer treated by radical surgery

Nagell, J.R. van; Donaldson, Elvis S.; Parker, Joseph C.; Dyke, A. H. Van; Wood, E. G.

doi:10.1016/0090-8258(77)90018-x

Cited by 93 publications

(15 citation statements)

References 20 publications

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“…The 17% overall incidence of pelvic lymph node metastases in the current study was very low compared to the percentage of positivity found in this patient population without induction chemotherapy, which is as high as 80% according to some series (21)(22)(23) . In addition, this frequency of positive nodes seems lower than that observed in other patients receiving other schemes of induction chemotherapy (24,25) suggesting the efficacy of the cisplatingemcitabine combination.…”

Section: Discussioncontrasting

confidence: 77%

Type III radical hysterectomy after induction chemotherapy for patients with locally advanced cervical carcinoma

Lopez-Graniel,

Reyes,

Chanona

et al. 2001

Int J Gynecol Cancer

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Neoadjuvant chemotherapy followed by surgery is a promising approach in locally advanced cervical carcinoma. The aim of this study was to evaluate the feasibility, technical aspects, and clinical results of surgery after induction chemotherapy in this patient population. Forty-one untreated cervical carcinoma patients staged as IB2 to IIIB received three 21-day courses of cisplatin 100mg/m2on day 1 and gemcitabine 1000 mg/m2 on days 1 and 8 followed by surgery or concomitant chemoradiation. The response to chemotherapy, operability, surgical/pathological findings, disease-free period, and survival of the surgically treated patients were evaluated. All 41 patients were evaluated for toxicity and 40 were evaluated for response. The overall objective response rate was 95% (95% confidence interval 88%–100%), and was complete in three patients (7.5%) and partial in 35 (87.5%). Granulocytopenia grades 3/4 occurred in 13.8% and 3.4% of the courses, respectively, whereas nonhematological toxicity was mild. Twenty-three patients underwent type III radical hysterectomy. Mean duration of surgery was 3.8 h (range 2:30–5:20), median estimated blood loss was 670 ml and median hospital stay was 5.2 days. Intraoperative complications occurred in one case (venous injury). In all but one case the resection margins were negative. Four patients (17%) had positive nodes (one node each); six (26%) had complete pathologic response, three (13%) had microscopic; and 14 (60%) macroscopic residual disease. At 24 months of maximum follow-up (median 20), the disease-free and overall survival rates were 59% and 91%, respectively. Induction chemotherapy with cisplatin/gemcitabine produced a high response rate and did not increase the difficulty of surgery. Operating time, blood loss, intraoperative complications, and hospital stay were all within the range observed for type III hysterectomy in early stage patients. We therefore conclude that type III radical hysterectomy is feasible in locally advanced cervical cancer patients who respond to chemotherapy.

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Section: Discussioncontrasting

confidence: 77%

Type III radical hysterectomy after induction chemotherapy for patients with locally advanced cervical carcinoma

Lopez-Graniel,

Reyes,

Chanona

et al. 2001

Int J Gynecol Cancer

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“…The stage of disease is determined by a combination of clinical examination (palpation, biopsy, conization, colposcopy, cystoscopy, and sigmoidoscopy) and conventional radiologic evaluation (chest and bone radiographs, intravenous pyelogram, and barium enema). The FIGO staging system is based exclusively on the concept of local spread of tumor and does not take into account lymphadenopathy or other significant prognostic factors such as depth of invasion, which may be more reliable predictors of relapse and patient survival than the FIGO stage [11][12][13][14][15]. Recently, the FIGO staging system has been updated to incorporate tumor size, subdividing stage Ib into lesions less than or greater than 4 cm in size.…”

Section: Clinical Stagingmentioning

confidence: 98%

Cervical carcinoma: role of imaging

Forstner

Hricak

1997

Abdom Imaging

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“…The probability of lymph node invasion is related to the depth of cancer in the cervix. [125][126][127][128][129][130][131][132][133][134][135][136] When the tumour is less than 3 mm deep (stage Ia1), the risk of positive nodes is below 1%, rising to 4% with a depth of 3-5 mm (stage Ia2). Sixteen per cent of women with stage Ib tumours have positive pelvic nodes.…”

Section: Surgerymentioning

confidence: 99%