scholarly journals Characteristics of patients with cervical cancer during pregnancy: a multicenter matched cohort study. An initiative from the International Network on Cancer, Infertility and Pregnancy

2019 ◽  
Vol 29 (4) ◽  
pp. 676-682 ◽  
Author(s):  
Michael J Halaska ◽  
Catherine Uzan ◽  
Sileny N Han ◽  
Robert Fruscio ◽  
Karina Dahl Steffensen ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Progression Free Survival ◽  
Premature Delivery ◽  
Matched Cohort ◽  
International Network ◽  
Free Survival ◽  
Matched Cohort Study ◽  
Gynecology And Obstetrics ◽  
Invasion Stage

BackgroundTreatment of cervical cancer during pregnancy is often complex and challenging. This study aimed to analyze current patterns of practice in the management of pregnant patients diagnosed with cervical cancer.MethodsThis was a matched cohort study comprising patients managed for cervical cancer during pregnancy from six European centers. Patient information was retrieved from the dataset of the International Network for Cancer, Infertility and Pregnancy from 1990 to 2012. Each center matched its patients with two non-pregnant controls for age (±5 years) and International Federation of Gynecology and Obstetrics (FIGO) 2009 stage. Information on age, histological type, grade, lymphovascular space invasion, stage, tumor size, method of diagnosis, site of recurrence, delivery, date of recurrence, and date of death was recorded. Progression-free survival was compared using multivariable Cox proportional hazards regression.ResultsA total of 132 pregnant patients and 256 controls were analyzed. The pregnant patients (median age 34 years, range 21–43) were diagnosed at a median gestational age of 18.4 weeks of pregnancy (range 7–39). Stage distribution during pregnancy was 14.4% for stage IA, 47.0% for IB1, 18.9% for IB2, and 19.7% for II-IV. For treatment during pregnancy, 17.4% of the patients underwent surgery, 16.7% received neoadjuvant chemotherapy, 26.5% delayed their treatment, 12.9% had a premature delivery, and 26.5% had their pregnancy terminated. Median follow-up was 84 months (67 months for pregnant and 95 months for non-pregnant patients). The unadjusted hazard ratio of pregnancy for progression-free survival was 1.18 (95% confidence interval 0.74 to 1.88).ConclusionSurgery and chemotherapy is increasingly used in the management of pregnant patients with cervical cancer and prognosis is similar to that of non-pregnant patients.

Stage IVA cervical cancer: outcomes of disease related complications and treatment

2020 ◽  
pp. ijgc-2019-000386
Author(s):  
Beman Roy Khulpateea ◽  
Annette Paulson ◽  
Matthew Carlson ◽  
David Scott Miller ◽  
Jayanthi Lea
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Progression Free Survival ◽  
Percutaneous Nephrostomy ◽  
Emergency Department Visits ◽  
Term Survival ◽  
Histologic Subtype ◽  
Free Survival ◽  
Gynecology And Obstetrics

IntroductionStage IVA cervical cancer is an uncommon diagnosis. The course of the disease and the complications of treatment are not well characterized. The goal of this study was to report treatment outcomes of patients with stage IVA cervical cancer.MethodsA single institution retrospective review was carried out of all patients treated for stage IVA cervical cancer from January 2008 to July 2017. Patients were clinically staged using the International Federation of Gynecology and Obstetrics (FIGO) 2009 staging criteria for cervical cancer. Inclusion criteria were patients with stage IVA cervical cancer of any histologic subtype, including patients with evidence of para-aortic lymph node involvement, treated at the institution during this time period. Overall survival and progression free survival were calculated using the Kaplan–Meyer method. Comparisons between survival were done using the Cox proportional hazards regression model and the log rank test.ResultsWe identified 25 patients with stage IVA cervical cancer. Mean age at diagnosis was 54 years (range 27–77). Squamous cell carcinoma was the histologic diagnosis in 24 of 25 patients (96%), with 1 case of small cell carcinoma (4%). 21 patients completed a full course of radiation. The median overall survival for patients who completed their treatment was 60 months (range 3–136), with a 2 year overall survival of 63%. The median progression free survival was 27 months (range 0–125), with a 2 year progression free survival of 40%. 11 of 25 patients (44%) developed fistulas during the course of their disease, and 55% of these were complex fistulas. 19 of 25 (76%) patients had a percutaneous nephrostomy for either hydronephrosis or diversion of vesicovaginal fistula. 111 unplanned admissions occurred among the 25 patients, and infections of the urinary tract was implicated in 46 (41%) of these. The cohort had a total of 92 emergency department visits, with pain control (36%) and medication refills (15%) being the most common presentations.DiscussionPatients with stage IVA cervical cancer may have substantial long term survival, although the sequelae of disease and treatment is associated with significant morbidity. Symptoms of fistula, percutaneous nephrostomy complications, and chronic pain present unique issues that require extensive supportive care.

Long-term cervical cancer survivors suffer from pelvic floor symptoms: A cross-sectional matched cohort study

2010 ◽  
Vol 117 (2) ◽  
pp. 281-286 ◽  
Author(s):  
M.H. Hazewinkel ◽  
M.A.G. Sprangers ◽  
J. van der Velden ◽  
C.H. van der Vaart ◽  
L.J.A. Stalpers ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Pelvic Floor ◽  
Cancer Survivors ◽  
Matched Cohort ◽  
Cross Sectional ◽  
Matched Cohort Study ◽  
Pelvic Floor Symptoms

scholarly journals UGT1A1 polymorphism has a prognostic effect in patients with stage IB or II uterine cervical cancer and one or no metastatic pelvic nodes receiving irinotecan chemotherapy

2020 ◽  
Author(s):  
Hideki Matsuoka ◽  
Ryusuke Murakami ◽  
Kaoru Abiko ◽  
Ken Yamaguchi ◽  
Akihito Horie ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Side Effects ◽  
Lymph Nodes ◽  
Progression Free Survival ◽  
Conditional Inference ◽  
Free Survival ◽  
Metastatic Lymph Nodes ◽  
Ugt1a1 Polymorphism ◽  
Metastatic Lymph ◽  
Gynecology And Obstetrics

Abstract Background : Uridine diphosphate glucuronosyltransferase 1 family polypeptide A1 (UGT1A1 ) is a predictive biomarker for the side-effects of irinotecan; irinotecan chemotherapy reduces the volume of tumors harboring UGT1A1 polymorphisms. We aimed to determine whether UGT1A1 polymorphisms can predict progression-free survival in patients with local cervical cancer treated with irinotecan. Methods : We retrospectively analyzed the data of 51 patients with cervical cancer treated at a single institution between 2010 and 2015. All patients were diagnosed with the 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IB1, IB2, IIA, or IIB squamous cell carcinoma, underwent radical hysterectomy, and received irinotecan chemotherapy as neoadjuvant and/or adjuvant treatment. All patients were examined for irinotecan side effects using UGT1A1 tests. Conditional inference tree and survival analyses were performed considering stage, age, UGT1A1 status, and the number of metastatic lymph nodes to determine primary factors associated with progression-free survival. Results : The tree-structured survival model determined high recurrence-risk factors related to progression-free survival. The most relevant factor was ≥2 metastatic lymph nodes (p = 0.004). The second most relevant was UGT1A1 genotype (p = 0.024). Among patients with ≤1 metastatic lymph node, those with UGT1A1 polymorphisms benefited from irinotecan chemotherapy and demonstrated significantly longer progression-free survival (p = 0.020) than those with wild-type UGT1A1 . Conclusion : Irinotecan chemotherapy has the potential to benefit patients with cervical cancer, UGT1A1 polymorphism, and ≤1 metastatic lymph nodes.

scholarly journals Impact of micrometastasis or isolated tumor cells on recurrence and survival in patients with early cervical cancer: SENTICOL Trial

2019 ◽  
Vol 29 (3) ◽  
pp. 447-452 ◽  
Author(s):  
Benedetta Guani ◽  
Maxence Dorez ◽  
Laurent Magaud ◽  
Annie Buenerd ◽  
Fabrice Lecuru ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Tumor Cells ◽  
Disease Free Survival ◽  
Isolated Tumor Cells ◽  
Free Survival ◽  
Gynecology And Obstetrics ◽  
Invasion Stage ◽  
Early Cervical Cancer ◽  
The Impact

ObjectivesThe aim of this study was to evaluate the impact of micrometastasis and isolated tumor cells on disease recurrence in patients with early-stage cervical cancer.MethodsWe included patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA1 with lymphvascular space invasion, stage IA2, and IB1 who participated in the SENTICOL1 trial. A centralized histologic analysis with re-reading and ultrastaging was performed 3 months after surgery and treatment was not impacted by findings from our study. Patients were followed for 3 years and outcomes were compared according to prognostic factors.ResultsA total of 139 patients were included and 13 recurrences were found. There were two recurrences in patients with positive sentinel lymph node (SLN) (one macrometastases and one micrometastases) and 11 recurrences in patients with negative lymph nodes (sentinel or non-sentinel). Among patients with positive SLN for micrometastases there was only one recurrence. No patient with isolated tumor cells on their lymph nodes experienced a recurrence. There was a significant decrease in disease-free survival in patients aged >50 years (p = 0.01).ConclusionEvidence of micrometastasis or isolated tumor cells in the SLN of untreated patients with early cervical cancer in the SENTICOL1 trial did not impact progression-free survival.

scholarly journals Matched Cohort Study on Patients with Cervical Cancer Diagnosed During Pregnancy

2014 ◽  
Vol 25 ◽  
pp. iv320
Author(s):  
F. Amant ◽  
C. Uzan ◽  
S.N. Han ◽  
R. Fruscio ◽  
K. Dahl Steffensen ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Matched Cohort ◽  
Matched Cohort Study
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