Prognostic Value of Human Copper Transporter 1 (hCtr1) in Cervical Cancer Patients Treated With Radical Hysterectomy and Adjuvant Chemoradiation Therapy or Salvage Chemoradiation Therapy at Recurrence

Objective:To evaluate whether the use of triweekly combination chemotherapy together with radiation exerts a more beneficial systemic effect than weekly cisplatin chemoradiation in patients with cervical cancer after radical surgery.Methods:We retrospectively analyzed patients with stage IB1 to stage IIB cervical cancer who had undergone radical hysterectomy with pelvic lymph node dissection, followed by concurrent adjuvant chemoradiation therapy. The patients were divided into 2 groups: the triweekly combination chemotherapy group and the weekly cisplatin chemotherapy group. We evaluated the survival and adverse effects of the 2 groups.Results:In total, 201 patients were included. The mean duration of follow-up was 52.2 months. Of the 201 patients, 130 received triweekly combination chemotherapy, and 71 patients received weekly cisplatin chemotherapy as an adjuvant treatment. The 5-year disease-free survival was 82.2% for patients treated with weekly cisplatin chemotherapy and 74.3% for those treated with triweekly combination chemotherapy (P= 0.3929). The 5-year overall survival was 81.4% and 79.3% for the same treatment groups, respectively (P= 0.9833). The overall survival of the patients with stage IIB cervical cancer was marginally higher in the triweekly combination chemotherapy group than in the weekly cisplatin group (P= 0.0582). Leukopenia, neutropenia, thrombocytopenia, anemia, and hepatopathy were significantly more common in the triweekly combination chemotherapy group.Conclusions:The weekly cisplatin chemotherapy group experienced the same therapeutic effect as the triweekly combination chemotherapy group but with less toxicity. Therefore, weekly cisplatin chemotherapy is considered the more useful concurrent adjuvant chemoradiation regimen after radical surgery.

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The prognostic value of lymph node ratio in stage IIIC cervical cancer patients triaged to primary treatment by radical hysterectomy with systematic pelvic and para-aortic lymphadenectomy

Journal of Gynecologic Oncology ◽

10.3802/jgo.2020.31.e1 ◽

2020 ◽

Vol 31 (1) ◽

Author(s):

Koray Aslan ◽

Mehmet Mutlu Meydanli ◽

Murat Oz ◽

Yusuf Aytac Tohma ◽

Ali Haberal ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Cancer Patients ◽

Radical Hysterectomy ◽

Prognostic Value ◽

Lymph Node Ratio ◽

Primary Treatment ◽

Stage Iiic ◽

Node Ratio

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Pre-hysterectomy cone biopsy is able to predict response in locally advanced cervical cancer patients submitted to neo-adjuvant chemoradiation

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2013.06.003 ◽

2013 ◽

Vol 39 (9) ◽

pp. 1025-1029 ◽

Cited By ~ 4

Author(s):

F. Fanfani ◽

A. Fagotti ◽

M.L. Gagliardi ◽

G. Ferrandina ◽

G. Monterossi ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Patients ◽

Locally Advanced ◽

Advanced Cervical Cancer ◽

Adjuvant Chemoradiation ◽

Locally Advanced Cervical Cancer ◽

Cone Biopsy

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Self-Reported Long-Term Autonomic Function After Laparoscopic Total Mesometrial Resection for Early-Stage Cervical Cancer: A Multicentric Study

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001045 ◽

2017 ◽

Vol 27 (7) ◽

pp. 1501-1507 ◽

Cited By ~ 4

Author(s):

Alessandro Lucidi ◽

Swetlana Windemut ◽

Marco Petrillo ◽

Margherita Dessole ◽

Giulio Sozzi ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Patients ◽

Radical Hysterectomy ◽

Vaginal Hysterectomy ◽

Early Stage ◽

Nerve Sparing ◽

Laparoscopic Radical Hysterectomy ◽

Early Stage Cervical Cancer ◽

Laparoscopic Assisted

ObjectivesThis multicentric retrospective study investigates the early and long-term self-reported urinary, bowel, and sexual dysfunctions in early-stage cervical cancer patients who submitted to laparoscopic total mesometrial resection (L-TMMR), total laparoscopic radical hysterectomy, vaginal-assisted laparoscopic radical hysterectomy, and laparoscopic-assisted radical vaginal hysterectomy.MethodsCervical cancer patients, FIGO (International Federation of Gynecology and Obstetrics) stage IA2–IB1/IIA1 who submitted to nerve-sparing radical hysterectomy were recruited. Pelvic functions were assessed within 30 days (early outcome) and 12 months after surgery (long-term outcome).ResultsTwo hundred thirteen subjects receiving nerve-sparing radical hysterectomy were enrolled. Laparoscopic total mesometrial resection was performed in 46 patients (21.6%), total laparoscopic radical hysterectomy in 65 patients (30.5%), vaginal-assisted laparoscopic radical hysterectomy in 54 patients (25.4%), and laparoscopic-assisted radical vaginal hysterectomy in 48 women (22.5%). Operative time was significantly lower in the L-TMMR group (240 minutes; range, 120–670 minutes; P = 0.001). The overall perioperative complication rate was 11.3%, with no statistically significant differences among the 4 groups. Stress incontinence and sensation of bladder incomplete emptying were detected, respectively, in 54 patients (25.6%) and 65 patients (30.7%) with a significantly lower prevalence among those in the L-TMMR group, which resulted, respectively, in 11.1% (P = 0.022) and 13.3% (P = 0.036). The prevalence rates of constipation, sensation of incomplete bowel emptying, and effort during evacuation were significantly higher among those in the L-TMMR group, resulting in, respectively, 37% (P = 0.001), 42.3% (P = 0.012), and 50% (P = 0.039). One hundred forty-nine patients (70%) were sexually active. Fifty-eight women (38.9%) reported low enjoyment, 83 women (55.7%) medium enjoyment, and 8 women (5.4%) reported high enjoyment, without statistically significant differences among the 4 groups.ConclusionsLaparoscopic total mesometrial resection is associated with improved long-term urinary autonomic functions and worse gastrointestinal autonomic outcome. Further larger prospective trials are needed to evaluate both the oncological and functional outcomes in order to establish the most appropriate surgical approach for early-stage cervical cancer patients.

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Does obesity influence the preferred treatment approach for early-stage cervical cancer? A cost-effectiveness analysis

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2021-003004 ◽

2021 ◽

pp. ijgc-2021-003004

Author(s):

Jacqueline A Bohn ◽

Miriam L Hernandez-Zepeda ◽

Alyssa R Hersh ◽

Elizabeth G Munro ◽

Jenna M Kahn ◽

...

Keyword(s):

Body Mass Index ◽

Cervical Cancer ◽

Cost Effectiveness ◽

Minimally Invasive ◽

Body Mass ◽

Radical Hysterectomy ◽

Early Stage ◽

Chemoradiation Therapy ◽

The Body ◽

Early Stage Cervical Cancer

ObjectiveAbdominal radical hysterectomy in early-stage cervical cancer has higher rates of disease-free and overall survival compared with minimally invasive radical hysterectomy. Abdominal radical hysterectomy may be technically challenging at higher body mass index levels resulting in poorer surgical outcomes. This study sought to examine the influence of body mass index on outcomes and cost effectiveness between different treatments for early-stage cervical cancer.MethodsA Markov decision-analytic model was designed using TreeAge Pro software to compare the outcomes and costs of primary chemoradiation versus surgery in women with early-stage cervical cancer. The study used a theoretical cohort of 6000 women who were treated with abdominal radical hysterectomy, minimally invasive radical hysterectomy, or primary chemoradiation therapy. We compared the results for three body mass index groups: less than 30 kg/m2, 30–39.9 kg/m2, and 40 kg/m2 or higher. Model inputs were derived from the literature. Outcomes included complications, recurrence, death, costs, and quality-adjusted life years. An incremental cost-effectiveness ratio of less than $100 000 per quality-adjusted life year was used as our willingness-to-pay threshold. Sensitivity analyses were performed broadly to determine the robustness of the results.ResultsComparing abdominal radical hysterectomy with minimally invasive radical hysterectomy, abdominal radical hysterectomy was associated with 526 fewer recurrences and 382 fewer deaths compared with minimally invasive radical hysterectomy; however, abdominal radical hysterectomy resulted in more complications for each body mass index category. When the body mass index was 40 kg/m2 or higher, abdominal radical hysterectomy became the dominant strategy because it led to better outcomes with lower costs than minimally invasive radical hysterectomy. Comparing abdominal radical hysterectomy with primary chemoradiation therapy, recurrence rates were similar, with more deaths associated with surgery across each body mass index category. Chemoradiation therapy became cost effective when the body mass index was 40 kg/m2 or higher.ConclusionWhen the body mass index is 40 kg/m2 or higher, abdominal radical hysterectomy is cost saving compared with minimally invasive radical hysterectomy and primary chemoradiation is cost effective compared with abdominal radical hysterectomy. Primary chemoradiation may be the optimal management strategy at higher body mass indexes.

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