Early-stage, high-grade neuroendocrine cervical carcinoma

ObjectivePatients with early-stage, high-grade neuroendocrine cervical carcinoma typically undergo radical hysterectomy with pelvic lymphadenectomy followed by adjuvant radiotherapy and/or chemotherapy. To explore the role of radical surgery in patients with this disease, who have a high likelihood of undergoing postoperative adjuvant therapy, we aimed to determine the rate of parametrial involvement and the rate of parametrial involvement without other indications for adjuvant treatment in these patients.MethodsWe retrospectively studied patients in the Neuroendocrine Cervical Tumor Registry (NeCTuR) at our institution to identify those with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IA1-IB2, high-grade neuroendocrine cervical carcinoma who underwent up-front radical surgery with or without adjuvant therapy.ResultsOne hundred patients met the inclusion criteria. The median age was 35 years (range 22–65), and 51% (51/100) had pure high-grade neuroendocrine carcinoma. No patient had a tumor >4 cm or suspected parametrial or nodal disease before surgery. Ten patients (10%) had microscopic parametrial compromise in the final surgical specimens. Ninety-four (94%) patients underwent nodal assessment, and 19 (19%) had positive nodes. Ten patients underwent both sentinel lymph node biopsy and pelvic lymphadenectomy, and none had false-negative findings. Patients with parametrial compromise were more likely to have positive pelvic nodes (80% vs 12%, p<0.0001), and a positive vaginal margin (20% vs 1%, p=0.03). All patients with parametrial compromise had lymphovascular space invasion (100% vs 73%, p=0.10). Of the 100 patients, 95 (95%) were recommended adjuvant therapy and 89 (89%) were known to have received it. Adjuvant pelvic radiotherapy reduced the likelihood of local recurrence by 62%.ConclusionsIn carefully selected patients with high-grade neuroendocrine cervical carcinoma, the rate of microscopic parametrial involvement is 10%. As most patients receive adjuvant treatment, we hypothesize that simple hysterectomy may be adequate when followed by adjuvant radiotherapy with concurrent cisplatin and etoposide followed by additional chemotherapy.

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Immunohistochemical expression of p53, bcl-2, and p21WAF1/CIP1 in early cervical carcinoma: Correlation with clinical outcome

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200205000-00009 ◽

2002 ◽

Vol 12 (3) ◽

pp. 290-298 ◽

Cited By ~ 3

Author(s):

M Graflund ◽

B Sorbe ◽

M Karlsson

Keyword(s):

Survival Rate ◽

Clinical Outcome ◽

Cervical Carcinoma ◽

Early Stage ◽

Tumor Grade ◽

Figo Stage ◽

Immunohistochemical Expression ◽

Cancer Specific Survival ◽

Term Survival ◽

Cervical Carcinomas

Abstract.Graflund M, Sorbe B, Karlsson M. Immunohistochemical expression of p53, bcl-2, and p21 WAF1/CIP1 in early cervical carcinoma: Correlation with clinical outcome.The objective of this study was to assess the value of p53, bcl-2, and p21WAF1/CIP1 immunoreactivity as predictors of pelvic lymph node metastases (LNM), recurrences, and death due to the disease in early stage (FIGO I-II) cervical carcinomas. FIGO stage, type of histopathology, and tumor grade were also evaluated in this series of patients treated by radical hysterectomy (Wertheim-Meigs) between 1965 and 1990. A total of 172 patients were included. A tumor was regarded as positive when more than 30% of the neoplastic cells exhibited immunoreactivity. Positive immunostaining was found in 8.9% for p53, in 43.5% for bcl-2, and in 25.0% for p21WAF1/CIP1. None of them was able to predict LNM or clinical outcome. Presence of LNM, tumor recurrence, and death from disease were significantly associated with the FIGO stage (P = 0.014, P = 0.009, and P = 0.001, respectively). The 5-year cancer-specific survival rate was 91.6% and the overall survival rate was 90.5%. It was concluded that immunohistochemically detected p53, bcl-2, and p21WAF1/CIP1 appeared to be of no predictive value with regard to LNM, tumor recurrences, or long-term survival in early cervical carcinomas.

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Prognostic factors associated with overall survival in presumed early stage, high-grade serous ovarian cancer: an analysis of the SEER cancer database

Gynecologic Oncology ◽

10.1016/s0090-8258(21)01119-7 ◽

2021 ◽

Vol 162 ◽

pp. S246

Author(s):

Kevin Kremer ◽

Matthew Carlson ◽

Jessica Lee ◽

Salvatore Lococo ◽

David Miller ◽

...

Keyword(s):

Ovarian Cancer ◽

Overall Survival ◽

Prognostic Factors ◽

Early Stage ◽

High Grade ◽

Serous Ovarian Cancer ◽

Factors Associated

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Adenocarcinoma as an independent risk factor for early-stage intermediate-risk cervical carcinoma

Gynecologic Oncology ◽

10.1016/j.ygyno.2010.12.249 ◽

2011 ◽

Vol 120 ◽

pp. S104-S105

Author(s):

C. Mathews ◽

S. Goodrich ◽

R. Farrell ◽

C. DeSimone ◽

L. Seamon ◽

...

Keyword(s):

Risk Factor ◽

Cervical Carcinoma ◽

Independent Risk Factor ◽

Early Stage ◽

Intermediate Risk

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Aggressive Salivary Malignancies at Early Stage: Outcomes and Implications for Treatment

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489417702655 ◽

2017 ◽

Vol 126 (7) ◽

pp. 525-529 ◽

Cited By ~ 5

Author(s):

Robert W. Eppsteiner ◽

Jonathan W. Fowlkes ◽

Carryn M. Anderson ◽

Robert A. Robinson ◽

Nitin A. Pagedar

Keyword(s):

Radiation Therapy ◽

Early Stage ◽

Relative Survival ◽

Carcinoma Ex Pleomorphic Adenoma ◽

Adjuvant Radiation ◽

Major Salivary Gland ◽

High Grade ◽

Duct Carcinoma ◽

The Impact ◽

Case Basis

Background: Few studies have examined whether the use of adjuvant treatment impacts survival for early stage high-grade salivary tumors. Methods: A retrospective review of the SEER database between 1973 and 2012 was performed. Patients with high-grade major salivary gland tumors including salivary duct carcinoma, carcinoma ex-pleomorphic adenoma, high-grade mucoepidermoid carcinoma, or adenocarcinoma, NOS were identified. Only stage I-II tumors were included. The impact of radiation status on observed and relative survival was examined. Results: Five hundred seventy-four patients with high-grade, early stage salivary tumors met inclusion criteria. Sixty-seven percent of patients received radiation therapy. There was no difference in observed or relative survival based on having received radiation. Conclusions: Adjuvant radiation is indicated for advanced stage tumors or early stage tumors with adverse features. For early stage tumors without adverse features, there was no survival benefit from radiation therapy. Adjuvant radiation should be decided on a case-by-case basis for these patients.

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Squamous Cell Carcinoma in a Calyceal Diverticulum Detected by Percutaneous Nephroscopic Biopsy

Case Reports in Oncological Medicine ◽

10.1155/2018/3508537 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Taku Mitome ◽

Tadashi Tabei ◽

Yukio Tsuura ◽

Kazuki Kobayashi

Keyword(s):

Computed Tomography ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Early Stage ◽

High Grade ◽

Curative Intent ◽

The Matrix ◽

Calyceal Diverticulum ◽

Pathological Assessment

A 73-year-old woman was referred to our department with a complaint of asymptomatic gross hematuria. Dynamic computed tomography revealed a complicated (Bosniak type IIF) cyst in the upper pole of her right kidney, which was diagnosed as a calyceal diverticulum. The diagnosis was confirmed by ureteroscopy. The diverticulum was filled with a soft protein matrix that was difficult to completely remove from the inner surface of the calyceal diverticulum. Endoscopy combined with intrarenal surgery (ECIRS) was performed to completely remove the matrix. Percutaneous nephroscopy further revealed papillary lesions on the surface of the diverticulum, confirmed as squamous cell carcinoma on pathological assessment. A laparoscopic right radical nephroureterectomy was performed, with curative intent. Pathological assessment confirmed a high-grade squamous cell carcinoma with renal parenchymal invasion (pT3). Although carcinomas in a calyceal diverticulum are highly uncommon, when present, these tend to be high-grade neoplasms that deeply invade the parenchymal wall. As the effective management of these lesions is difficult, early-stage diagnosis is required for curative treatment. We report the case of squamous cell carcinoma in a calyceal diverticulum that was difficult to diagnose on preoperative computed tomography, urinal cytology examination, and ureteroscopy but was found during ECIRS.

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