scholarly journals Cervical Cancer Staging in Saudi Arabia Clinicoradiological Correlation

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Nisreen Anfinan
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
False Negative ◽  
Cancer Staging ◽  
Clinical Staging ◽  
Mri Findings ◽  
Pelvic Mri ◽  
Rectal Involvement ◽  
Sensitivity Specificity ◽  
Bladder Invasion

Objective. The aim of this study was to compare the finding of pelvic MRI with clinical staging using cystoscopy and sigmoidoscopy for cervical cancer patients. Method. We reviewed all patients with cervical cancer between January 2001 and December 2015. We correlate the clinical examination, cystoscopy, and sigmoidoscopy with MRI findings. Result. A total of 152 patients were enrolled. 114 (74.9%) were with locally advanced cervix cancer. The true positives for MRI in the detection of parametrium were in 94 patients, with sensitivity, specificity, positive, PPV, and NPV of 72%, 82%, 96%, and 33%, respectively. The false negative of the MRI to detect the bladder invasion was 2. Nineteen patients reported having bladder invasion on MRI not confirmed by cystoscopy. None of the patients who had a negative rectal invasion by MRI were found to have rectal involvement by sigmoidoscopy with a specificity of 91%. Conclusion. The combined MRI and clinical staging for parametrial evaluation should still be carried out for the staging of cervical cancer. However, in the absence of the bladder and the rectal invasion in the MRI, it will be safe to avoid the need for a cystoscopy and/or sigmoidoscopy for complete staging in the majority of patients with cervical cancer.

scholarly journals Carbon-ion radiotherapy for locally advanced cervical cancer with bladder invasion

2016 ◽  
Vol 57 (6) ◽  
pp. 684-690 ◽  
Author(s):  
Shintaro Shiba ◽  
Masaru Wakatsuki ◽  
Shingo Kato ◽  
Tatsuya Ohno ◽  
Noriyuki Okonogi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Survival Rate ◽  
Local Control ◽  
Locally Advanced ◽  
Carbon Ion Radiotherapy ◽  
Therapeutic Effects ◽  
Advanced Cervical Cancer ◽  
Carbon Ion ◽  
Locally Advanced Cervical Cancer ◽  
Bladder Invasion

Abstract The purpose of this study was to evaluate the efficacy and toxicities of carbon-ion radiotherapy (C-ion RT) for locally advanced cervical cancer with bladder invasion by a subset analysis of pooled data from eight prospective clinical trials at the National Institute of Radiological Sciences. Between June 1995 and January 2014, 29 patients with locally advanced cervical cancer with bladder invasion were identified. The median age was 56 years old (range 31–79 years old). The median tumor size at diagnosis on magnetic resonance imaging was 6.7 cm (range 3.5–11.0 cm). Histologically, 20 patients had squamous cell carcinoma and 9 had adenocarcinoma. C-ion RT was performed as a dose-escalation study in the initial trials. All patients received prophylactic whole-pelvic or extended-field irradiation and local boost. The total dose to the cervical tumor was 52.8–74.4 Gy (relative biological effectiveness) in 20 or 24 fractions. Weekly cisplatin (40 mg/m2/week, five cycles) was concurrently given to four patients. The median follow-up of all patients was 28.6 months (range 8.8–238.6 months). Grade 2 or higher late complications in the bladder were observed in eight patients, with seven developing vesicovaginal fistula. Six patients had Grade 2 or higher complications in the rectosigmoid colon. The 3-year overall survival rate was 47%, the 3-year local control rate was 66%, and the 3-year disease-free survival rate was 28%. In this study, C-ion RT showed favorable local control with reasonable toxicities, but the results were still unsatisfactory. We have the expectation of improvement of therapeutic effects by using C-ion RT with concurrent chemotherapy.

Laparoscopy-Assisted Transvaginal Total Exenteration for Locally Advanced Cervical Cancer with Bladder Invasion after Radiotherapy

2004 ◽  
Vol 18 (9) ◽  
pp. 867-870 ◽  
Author(s):  
Meng-Yeh Lin ◽  
Eric W. Fan ◽  
Allen W. Chiu ◽  
Yu-Feng Tian ◽  
Ming-Ping Wu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Bladder Invasion

scholarly journals Treatment protocols for cervical cancer

2002 ◽  
Vol 55 (3-4) ◽  
pp. 105-108 ◽  
Author(s):  
Tamara Vujkov ◽  
Milica Zivaljevic ◽  
Petar Novakovic ◽  
Marko Erak ◽  
Jelka Rajovic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Developed Countries ◽  
Pelvic Lymphadenectomy ◽  
Clinical Staging ◽  
Early Screening ◽  
Treatment Protocols ◽  
Therapeutic Modalities ◽  
Paraaortic Lymph Nodes

Introduction Cervical cancer is the second most common cancer in women worldwide and the second cause of cancer death among women. About 95% (90% in developed countries) of invasive carcinomas are of sqamous types, and 5% (10% in developed countries) are adenocarcinomas. FIGO classification of cervical carcinomas, based on clinical staging and prognostic factor dictate therapeutic procedures and help in designing treatment protocols. Therapeutic modalities Surgical therapy includes conization, radical hysterectomy with pelvic lymphadenectomy and palliative operation urinary diversion and colostomy. Radiotherapy, brachytherapy and teletherapy are most recently combined with chemotherapy as concurrent chemoradiation. Discussion and conclusion No change in therapeutic modalities will ever decrease mortality rate of cervical carcinoma as much as education, prevention and early screening. The 5-year survival for locally advanced disease has not improved during the last 40 years as a result of failure to deliver therapy to the paraaortic region. Paraaortic lymph nodes should be evaluated before therapy planning by different imaging procedures, or more exactly by surgical staging: laparoscopy or laparotomy. Radical operations of cervical carcinoma should be performed by experienced surgeons, educated for this type of operation, with sufficient number of cases.

scholarly journals Survival of a cohort of women with cervical cancer diagnosed in a Brazilian cancer center

2011 ◽  
Vol 45 (4) ◽  
pp. 661-667 ◽  
Author(s):  
Claudio Calazan do Carmo ◽  
Ronir Raggio Luiz
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Cox Model ◽  
Tumor Staging ◽  
Invasive Cervical Cancer ◽  
Locally Advanced ◽  
Clinical Staging ◽  
Southeastern Brazil ◽  
Cancer Center

OBJECTIVE: To assess overall survival of women with cervical cancer and describe prognostic factors associated. METHODS: A total of 3,341 cases of invasive cervical cancer diagnosed at the Brazilian Cancer Institute, Rio de Janeiro, southeastern Brazil, between 1999 and 2004 were selected. Clinical and pathological characteristics and follow-up data were collected. There were performed a survival analysis using Kaplan-Meier curves and a multivariate analysis through Cox model. RESULTS: Of all cases analyzed, 68.3% had locally advanced disease at the time of diagnosis. The 5-year overall survival was 48%. After multivariate analysis, tumor staging at diagnosis was the single variable significantly associated with prognosis (p<0.001). There was seen a dose-response relationship between mortality and clinical staging, ranging from 27.8 to 749.6 per 1,000 cases-year in women stage I and IV, respectively. CONCLUSIONS: The study showed that early detection through prevention programs is crucial to increase cervical cancer survival.

scholarly journals Predictive Role of MRI and 18F FDG PET Response to Concurrent Chemoradiation in T2b Cervical Cancer on Clinical Outcome: A Retrospective Single Center Study

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 659 ◽  
Author(s):  
Anna Myriam Perrone ◽  
Giulia Dondi ◽  
Manuela Coe ◽  
Martina Ferioli ◽  
Silvi Telo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Tumor Response ◽  
Locally Advanced ◽  
False Negative ◽  
Response To Therapy ◽  
Imaging Tool ◽  
Pet Ct ◽  
Before And After ◽  
Radiological Response

Tumor response in locally advanced cervical cancer (LACC) is generally evaluated with MRI and PET, but this strategy is not supported by the literature. Therefore, we compared the diagnostic performance of these two techniques in the response evaluation to concurrent chemoradiotherapy (CCRT) in LACC. Patients with cervical cancer (CC) stage T2b treated with CCRT and submitted to MRI and PET/CT before and after treatment were enrolled in the study. All clinical, pathological, therapeutic, radiologic and follow-up data were collected and examined. The radiological response was analyzed and compared to the follow-up data. Data of 40 patients with LACC were analyzed. Agreement between MRI and PET/CT in the evaluation response to therapy was observed in 31/40 (77.5%) of cases. The agreement between MRI, PET/CT and follow-up data showed a Cohen kappa coefficient of 0.59 (95% CI = 0.267–0.913) and of 0.84 (95% CI = 0.636–1.00), respectively. Considering the evaluation of primary tumor response, PET/CT was correct in 97.5% of cases, and MRI in 92.5% of cases; no false negative cases were observed. These results suggest the use of PET/CT as a unique diagnostic imaging tool after CCRT, to correctly assess residual and progression disease.

scholarly journals Surgical versus clinical staging prior to primary chemoradiation in patients with cervical cancer FIGO stages IIB–IVA: oncologic results of a prospective randomized international multicenter (Uterus-11) intergroup study

2020 ◽  
Vol 30 (12) ◽  
pp. 1855-1861 ◽  
Author(s):  
Simone Marnitz ◽  
Audrey Tieko Tsunoda ◽  
Peter Martus ◽  
Marcelo Vieira ◽  
Renato Jose Affonso Junior ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Surgical Staging ◽  
Clinical Staging ◽  
Advanced Cervical Cancer ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Locally Advanced Cervical Cancer ◽  
Disease Free

ObjectiveRevised staging of patients with locally advanced cervical cancer is based on clinical examination, imaging, and potential surgical findings. A known limitation of imaging techniques is an appreciable rate of understaging. In contrast, surgical staging may provide more accurate information on lymph node involvement. The aim of this prospective study was to evaluate the impact of pre-treatment surgical staging, including removal of bulky lymph nodes, on disease-free survival in patients with locally advanced cervical cancer.MethodsUterus-11 was a prospective international multicenter study including patients with locally advanced cervical cancer who were randomized 1:1 to surgical staging (experimental arm) or clinical staging (control arm) followed by primary platinum-based chemoradiation. Patients with histologically proven squamous cell carcinoma, adenocarcinoma, or adenosquamous cancer International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IIB–IVA underwent gynecologic examination and pre-treatment imaging including abdominal computed tomography (CT) and/or abdominal magnetic resonance imaging (MRI). Patients had chest imaging (any of the following: X-ray, CT, or PET-CT). The primary endpoint was disease-free survival and the secondary endpoint was overall survival. An ad hoc analysis was performed after trial completion for cancer-specific survival. Randomization was conducted from February 2009 to August 2013.ResultsA total of 255 patients (surgical arm, n=130; clinical arm, n=125) with locally advanced cervical cancer were randomized. Of these, 240 patients were eligible for analysis. The two groups were comparable with respect to patient characteristics. The surgical approach was transperitoneal laparoscopy in most patients (96.6%). Laparoscopic staging led to upstaging in 39 of 120 (33%) patients. After a median follow-up of 90 months (range 1–123) in both arms, there was no difference in disease-free survival between the groups (p=0.084). For patients with FIGO stage IIB, surgical staging is superior to clinical staging with respect to disease-free survival (HR 0.51, 95% CI 0.30 to 0.86, p=0.011). In the post-hoc analysis, surgical staging was associated with better cancer-specific survival (HR 0.61, 95% CI 0.40 to 0.93, p=0.020).ConclusionOur study did not show a difference in disease-free survival between surgical and clinical staging in patients with locally advanced cervical cancer. There was a significant benefit in disease-free survival for patients with FIGO stage IIB and, in a post-hoc analysis, a cancer-specific survival benefit in favor of laparoscopic staging. The high risk of distant metastases in both arms emphasizes the need for further evaluation.

Sign in / Sign up

Export Citation Format

Share Document