A slow acetylator genotype associated with an increased risk of advanced cervical cancer

ObjectiveClinical benefit of surgical staging in locally advanced cervical cancer has not yet been proved. The goal of this study was to analyze the prognostic and therapeutic value of laparoscopic para-aortic lymphadenectomy with selective excision of suspicious pelvic nodes in patients with locally advanced cervical cancer.MethodsThis is a retrospective study including 109 women treated in a single institution from 2000 to 2009. The International Federation of Gynecology and Obstetrics stage was IB2 in 12 women, IIB in 58 women, and IIIB in 39 women. None had suspicious para-aortic nodes by presurgical imaging evaluation. All patients underwent extraperitoneal para-aortic laparoscopic lymphadenectomy with selective excision of enlarged pelvic nodes and received pelvic radiotherapy with concomitant chemotherapy. Extended lumboaortic radiation therapy was added to patients with metastatic para-aortic nodes. The mean ± SD follow-up time was 43.1 ± 33.7 months.ResultsMetastatic lymph nodes were identified in 23 (21.1%) of 109 patients in the para-aortic area and in 24 (53.3%) of 45 patients who underwent selective excision of pelvic nodes. Patients with nodal metastases had increased risk of mortality than those with negative nodes independently of the location (pelvic and/or para-aortic) of the metastases (hazard ratio, 4.07; 95% confidence interval, 1.36–12.16 for patients with pelvic metastases [P= 0.012]; and 3.73; 95% confidence interval, 1.38–10.09 for patients with para-aortic metastases [P= 0.010]). In the subset of women with para-aortic metastases treated by extended lumboaortic radiation therapy, neither the number of lymph nodes removed nor the number of positive nodes were associated with survival (P= 0.556 andP= 0.195, respectively).ConclusionPara-aortic and pelvic lymphadenectomy provides valuable information about mortality risk in patients with locally advanced cervical cancer.

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Postradiotherapy Outcome on Cervical Cancer Stage IIIB Patients with and without Paraaortic Lymph Nodes Enlargement

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v9i1.1438 ◽

2021 ◽

pp. 55-58

Author(s):

Fitriyadi Kusuma ◽

Sahat B. Matondang ◽

Laila Nuranna ◽

Gatot Purwoto ◽

Oni Khonsa ◽

...

Keyword(s):

Cervical Cancer ◽

Retrospective Cohort ◽

Primary Diagnosis ◽

Advanced Cervical Cancer ◽

First Sexual Intercourse ◽

Consecutive Sampling ◽

Increased Risk ◽

Lymph Node Enlargement ◽

Paraaortic Lymph Nodes ◽

Paraaortic Radiotherapy

Objective : To determine whether there are differences in clinical response after radiotherapy and 1 year survival in patients with advanced cervical cancer with and without enlargement of PALN.Method : An observational analytic study using a retrospective cohort method was done using consecutive sampling. The subjects of this study were all women with a primary diagnosis of stages IIB to IVB cervical cancer who came to the gynecological oncology clinic of Dr. Cipto Mangunkusumo National General Hospital and underwent MRI examination before undergoing treatment in January 2016 to May 2017Results: Among 76 subjects studied, there were 4 (5.1%) subjects who had enlarged PALN. There were no significant differences between the enlargement status of PALN and age (p = 0.829), age of first sexual intercourse (p = 0.33), parity (p = 0.642), mass diameter (p = 0.777). Patients with PALN enlargement have 2.13 times risk of having negative radiotherapy outcome (p = 0.02, OR 2.13, CI95% 1.12 – 4.07). There was no difference in 1-year survival between patients with and without enlargement of PALN (median 201 vs. 293, p = 0.072).Conclusion: Patients with PALN enlargement have increased risk of having negative radiotherapy outcome (p < 0.05). There were no differences in 1 year survival between patients with advanced cervical cancer with enlargement PALN.Keywords : cervical cancer, lymph node enlargement, paraaortic, radiotherapy. Abstrak Tujuan: Mengetahui adakah perbedaan respon klinis pascaradioterapi dan kesintasan 1 tahun pada pasien kanker serviks stadium lanjut dengan pembesaran KGB paraaorta dibandingkan tanpa pembesaran KGB paraaorta.Metode: Penelitian ini merupakan penelitian analitik observasional dengan menggunakan metode kohort retrospektif. Pengambilan sampel dilakukan dengan cara pengambilan sampel berturut-turut. Subyek penelitian ini adalah semua perempuan dengan diagnosis primer kanker serviks stadium IIB hingga IVB yang datang ke poliklinik Onkologi Ginekologi RSUPN Dr. Cipto Mangunkusumo dan menjalani pemeriksaan MRI sebelum dilakukan terapi pada bulan Januari 2016 hingga Mei 2017.Hasil: Dari 76 subjek yang diteliti, didapatkan sebanyak 4 (5,1%) subyek yang mengalami pembesaran KGB paraaorta. Tidak didapatkan perbedaan yang bermakna antara status pembesaran KGB paraaorta dan usia (p = 0,829), usia hubungan seksual pertama (p = 0,333), paritas (p = 0,642), dan diameter massa (p = 0,777). Pasien dengan pembesaran KGB paraaorta memiliki risiko 2,13 kali lipat (p = 0,02, OR 2,13, IK95% 1,12-4,07) memiliki risiko respon terapi negatif. Tidak terdapat perbedaan kesintasan 1 tahun antara pembesaran KGB paraaorta dan tidak (median 201 vs. 293, p = 0,072).Kesimpulan Pasien dengan pembesaran KGB paraaorta memiliki risiko lebih tinggi mengalami respon radioterapi negatif. (p < 0,05). Tidak terdapat kesintasan 1 tahun antara pasien kanker serviks stadium lanjut dengan dan tanpa pembesaran KGB.Kata kunci: kanker serviks, paraaorta, pembesaran KGB, radioterapi.

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Involvement of the XRCC1 Arg399Gln Gene Polymorphism in the Development of Cervical Carcinoma

The International Journal of Biological Markers ◽

10.5301/jbm.2011.8581 ◽

2011 ◽

Vol 26 (4) ◽

pp. 216-220 ◽

Cited By ~ 12

Author(s):

Andrzej Roszak ◽

Margarita Lianeri ◽

Pawel P. Jagodzinski

Keyword(s):

Cervical Cancer ◽

Statistical Power ◽

P Value ◽

Advanced Cervical Cancer ◽

Chi Square ◽

Xrcc1 Arg399gln ◽

Patients With Cancer ◽

Increased Risk ◽

Arg399gln Polymorphism ◽

Chi Square Test

Background Although infection with the human papillomavirus (HPV) is crucial to the development of cervical cancer, it is not considered a sufficient isolated factor to cause this malignancy. The association of the XRCC1 Arg399Gln (rs25487) polymorphism with cervical cancer has been demonstrated in some populations. Methods The XRCC1 Arg399Gln genetic variants were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in patients with advanced cervical cancer (n=189) and controls (n=308). Results We observed that patients with advanced cervical cancer having the Gln/Gln or Gln/Arg vs Arg/Arg genotype displayed a 1.726-fold increased risk of cervical cancer (95% confidence interval [CI]=1.158-2.572, p=0.007). The odds ratio (OR) for Gln/Gln vs Gln/Arg or Arg/Arg was 1.742 (95% CI=1.073-2.827; p=0.0236). We also found a significantly higher frequency of the XRCC1 399Gln allele in patients with cancer than in controls, with OR=1.489 (95% CI=1.148-1.930, p=0.0026). The p value of the chi-square test for the trend observed for the XRCC1 Arg399Gln polymorphism was also statistically significant (ptrend=0.002). The statistical power of this study amounted to 78% for the Gln/Gln or Gln/Arg genotypes and 61% for the Gln/Gln genotype. Conclusion Although the statistical power of our study did not reach 80%, we found a statistically significant association between the XRCC1 399Gln variant and the incidence of cervical cancer.

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