Risk factors for recurrence after laparoscopic radical trachelectomy in young women with early stage cervical cancer: Long-term outcomes of Korean Multicenter Study

2012 ◽  
Vol 125 ◽  
pp. S62-S63
Author(s):  
J. Park ◽  
W. Joo ◽  
M. Jung ◽  
D. Kim ◽  
Y. Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Young Women ◽  
Multicenter Study ◽  
Early Stage ◽  
Long Term Outcomes ◽  
Radical Trachelectomy ◽  
Early Stage Cervical Cancer ◽  
Risk Factors For Recurrence

scholarly journals Risk Factors for Recurrence after Robot-Assisted Radical Hysterectomy for Early-Stage Cervical Cancer: A Multicenter Retrospective Study

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3387
Author(s):  
Jordi Ponce ◽  
Sergi Fernandez-Gonzalez ◽  
Antonio Gil-Moreno ◽  
Pluvio J. Coronado ◽  
Jesús De la Rosa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Tumor Size ◽  
Early Stage ◽  
Tumor Grade ◽  
Robot Assisted ◽  
Invasive Approach ◽  
Early Stage Cervical Cancer ◽  
Risk Factors For Recurrence

This retrospective analysis aimed to assess the risk factors for recurrence in patients diagnosed with early-stage cervical cancer (≤IB1 or IIA1, FIGO 2009) undergoing robot-assisted radical hysterectomy in Spain and Portugal between 2009 and 2018. A second primary objective was to audit the oncological outcomes according to quality indicators (QI) proposed by the European Society of Gynecology Oncology (ESGO). The study population included 239 women. After a median follow-up of 51 months, recurrence occurred in 26 patients (10.9%). Independent factors for recurrence were clinical tumor size > 20 mm (hazard ratio (HR) 2.37), adenocarcinoma as histological type (HR 2.51), positive pelvic lymph nodes (HR 4.83), tumor grade 2 (HR 4.99), tumor grade 3 (HR 8.06), and having not performed sentinel lymph node biopsy (SLNB) (HR 4.08). All 5 QI selected were surpassed by our results. In patients with early-stage cervical cancer undergoing robotic radical hysterectomy, clinicians should be aware that tumor grade 2 and 3, tumor size > 20 mm, adenocarcinoma, positive pelvic nodes, and lack of performance of SLNB are risk factors for recurrence. Fulfillment of QI targets of the ESGO might be considered as an objective oncological outcome indicator supporting the minimally invasive approach for early-stage cervical cancer treatment.

Efficacy and toxicity of postoperative external beam radiotherapy or chemoradiation for early-stage cervical cancer

2020 ◽  
Vol 30 (12) ◽  
pp. 1878-1886
Author(s):  
Mick J E van den Akker ◽  
Nanda Horeweg ◽  
Jogchum Jan Beltman ◽  
Carien L Creutzberg ◽  
Remi A Nout
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Overall Survival ◽  
Risk Factor ◽  
High Risk ◽  
Early Stage ◽  
Free Survival ◽  
High Risk Factors ◽  
Early Stage Cervical Cancer ◽  
Risk Factors For Recurrence

ObjectiveThe aim of this study was to assess the impact of the evolving role of the addition of chemotherapy to postoperative radiotherapy on oncological outcomes and toxicity in patients with early-stage cervical cancer after radical hysterectomy.MethodsRetrospective cohort study of patients with stage IB1–IIB FIGO 2009 cervical cancer treated from November 1999 to May 2015 by primary surgery and radiotherapy (46–50.4 Gy in 1.8–2.0 Gy fractions) with or without concurrent cisplatin (40 mg/m2, 5–6 weekly cycles) with or without a brachytherapy boost. Chemotherapy was allocated depending on the risk factors for recurrence. Incidences of all outcomes were calculated using Kaplan–Meier’s methodology and compared by log-rank tests. Risk factors for recurrence and survival were identified using Cox’s proportional hazards models.ResultsA total of 154 patients were included, median follow-up was 9.6 years (IQR: 6.1–12.8). Five-year pelvic recurrence-free survival was 75.3%; 74.7% in patients with high-risk factors treated with radiotherapy; and 77.3% in those treated with chemoradiation (P=0.43). Distant metastasis-free survival at 5 years was 63.4%; 63.6% in high-risk patients after radiotherapy; and 57.1% after chemoradiation (P=0.36). Five-year overall survival was 63.9%: 66.8% and 51.6% after radiotherapy and after chemoradiation in patients with high-risk factors (P=0.37), respectively. Large tumor size was a risk factor for vaginal and pelvic recurrence, ≥2 involved lymph nodes was a significant risk factor for para-aortic recurrence and death. Mild treatment-related late toxicity was observed in 53.9% of the patients. Five-year severe (grade 3–5) late rectal, bladder, bowel, and vaginal toxicities were, respectively, 1.3%, 0%, 3.4%, and 0.9%. Any late severe toxicity was observed in 5.5% of patients treated with radiotherapy and in 15.3% of those treated with chemoradiation (P=0.07).ConclusionPostoperative (chemo)radiation for early-stage cervical cancer patients with risk factors for recurrence yields adequate pelvic tumor control, but overall survival is limited due to distant metastasis.

Radical Trachelectomy Performed During Pregnancy: A Review of the Literature

2016 ◽  
Vol 26 (4) ◽  
pp. 758-762 ◽  
Author(s):  
Mihai Emil Căpîlna ◽  
Belá Szabo ◽  
Janos Becsi ◽  
Nicolae Ioanid ◽  
Bogdan Moldovan
Keyword(s):  
Cervical Cancer ◽  
Young Women ◽  
Early Stage ◽  
Invasive Cervical Cancer ◽  
Review Of The Literature ◽  
Ongoing Pregnancy ◽  
Vaginal Route ◽  
Radical Trachelectomy ◽  
Medline Search ◽  
Early Stage Cervical Cancer

ObjectiveCervical cancer is one of the most frequent malignant diseases diagnosed during pregnancy. Abdominal or vaginal radical trachelectomies are fertility-preserving alternatives to radical hysterectomy for young women with early-stage cervical cancer that can be performed during ongoing pregnancy.MethodsA literature review of articles on this subject was conducted through a Medline search for articles published in English or French.ResultsAt this moment, 21 cervical cancer patients, including ours (4 stage IA2, 16 IB1, and 1 IB2) who underwent radical trachelectomy during pregnancy have been reported. Of these, 10 were performed by vaginal route and 11 were abdominal radical trachelectomies.ConclusionsRadical trachelectomy could be offered as an option for pregnant patients with early invasive cervical cancer. It may help women avoid the triple losses of a desired pregnancy, fertility, and motherhood.

Bulky Early-Stage Cervical Cancer (2-4 cm Lesions): Upfront Radical Trachelectomy or Neoadjuvant Chemotherapy Followed by Fertility-Preserving Surgery

2015 ◽  
Vol 25 (4) ◽  
pp. 722-728 ◽  
Author(s):  
Marie Plante
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Young Women ◽  
Early Stage ◽  
Oncologic Outcome ◽  
Radical Trachelectomy ◽  
Advantages And Disadvantages ◽  
Early Stage Cervical Cancer ◽  
Obstetrical Outcome ◽  
Few Data

AbstractRadical trachelectomy is now recognized as a valid treatment option for young women with early-stage cervical cancer with lesions measuring less than 2 cm. However, for women with bulky lesions measuring greater than 2cm, few data are available in the literature to guide management. There are currently 2 options available: either upfront radical trachelectomy or neoadjuvant chemotherapy followed by fertility-preserving surgery. Overall, both options offer very good oncologic outcome; however, the rate of fertility preservation and obstetrical outcome seem superior after neoadjuvant chemotherapy. Advantages and disadvantages of both options are discussed and a thorough literature review is provided. Issues to be further studied are also outlined.

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