Clinicopathological Analysis of Neuroendocrine Carcinoma of the Uterine Cervix: A Single-Institution Retrospective Review of 9 Cases

Aim. To evaluate the clinicopathological features affecting the recurrence and survival of 9 cases of neuroendocrine cancer of the cervix. Method. We retrospectively analyzed 9 cervical neuroendocrine cancer cases identified among 453 cervical cancer patients between 2004 and 2021 at Akdeniz University Gynecological Oncology Outpatient Clinic. Kaplan–Meier survival analysis was used for progression-free survival (PFS) and overall survival (OS). Mathematical functions of mean, standard deviation, median, Min–Max values, and frequencies were used for descriptive statistics. The categorical data were expressed in numbers and percentages (%). Results. Nine patients with neuroendocrine histological subtype were selected out of 453 patients diagnosed with cervical cancer (1.98%). The average overall survival time of the patients was 26 months. The 5-year survival rate was 53.3%, while the PFS was 62.5%. The most common subtype was small cell neuroendocrine cancer. Tumours were mostly locally advanced at the time of diagnosis. 3 patients’ stage was 1b2, while 4 patients were 2b, 1 patient was 3c2r, and 1 patient was 4b. All tumours showed the immunohistochemical staining properties of neuroendocrine cancer. The main treatment modality applied to our patients was surgery + adjuvant CRT. The most used chemotherapeutic agents were cisplatin/carboplatin and etoposide. Recurrence was found in 3 cases, including 5 deaths. Conclusion. Neuroendocrine tumour of the cervix is a rare subtype with a poor prognosis. Unfortunately, there is not yet a standard treatment protocol due to the limited number of comparative studies of surgery, chemotherapy, and radiotherapy based treatment schemes.

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TILs and Anti-PD1 Therapy: An Alternative Combination Therapy for PDL1 Negative Metastatic Cervical Cancer

Journal of Immunology Research ◽

10.1155/2020/8345235 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Huanhuan Yin ◽

Wei Guo ◽

Xiangling Sun ◽

Ruili Li ◽

Cuihua Feng ◽

...

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Combination Therapy ◽

Survival Time ◽

Response Rate ◽

Multivariate Analyses ◽

Objective Response ◽

Progression Free Survival ◽

Free Survival ◽

Kaplan Meier

Background. We investigated the efficacy of TILs and anti-PD1 combination therapy in patients with metastatic cervical cancer with low MSI expression and PDL1-negative. Methods. A total of 80 patients were put on TILs and anti-PD1 combination therapy, and the progression-free survival time (PFS) and overall survival time (OS) were assessed by Kaplan–Meier analysis. Univariate and multivariate analyses were performed to identify factors that could predict the prognosis of metastatic cervical cancer in the previously described patients. Results. The objective response rate was 25%, whereas the mPFS and mOS were 6.1 and 11.3 months, respectively. The therapeutic efficacy was influenced by the characteristics of TILs, infection with HPV, and development of fever just after the therapy. Conclusion. Overall, our results show that the combination therapy of TILs and anti-PD1 significantly improves the prognosis of metastatic cervical cancer.

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Chemoradiation in locally advanced cervical carcinoma: An analysis of cisplatin administration and other clinical prognostic factors

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16525 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16525-e16525

Author(s):

E. Nugent ◽

A. S. Case ◽

I. Zighelboim ◽

L. DeWitt ◽

P. H. Thaker ◽

...

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Locally Advanced ◽

Advanced Cervical Cancer ◽

Weekly Chemotherapy ◽

Locally Advanced Cervical Cancer ◽

Kaplan Meier ◽

Improve Compliance ◽

Cox Proportional Hazard Models ◽

Weekly Cisplatin

e16525 Background: The standard treatment for locally advanced cervical cancer is combination weekly cisplatin and radiotherapy (RT). Toxicity and compliance issues often result in failure to complete the recommended six cycles of weekly chemotherapy. Our objective was to retrospectively evaluate the effect of number of chemotherapy cycles and other clinical and pathologic factors on progression-free (PFS) and overall survival (OS). Methods: Between January 2004 and May 2007 we identified 118 patients at our institution with locally advanced cervical cancer (stage 1B2-IVA) treated with combined weekly cisplatin (40 mg/m2) and RT from chemotherapy log records. PFS and OS were evaluated for associations with number of chemotherapy cycles as well as other clinical and pathologic factors. Kaplan-Meier and Cox proportional hazard models were utilized for statistical analyses. Results: The median age and BMI were 51 years (25–86) and 29.2 kg/m2 (15–69). The majority of patients had stage IB2 or II disease (70%), squamous histology (91%), and size <6 cm (65%). Median RT duration was 50 days and 95% received brachytherapy. 30% of patients completed fewer than 6 cycles of chemotherapy and estimated PFS and OS were 63% and 75% respectively. 32 recurrences were detected with a median time to progression of 27 months. In multivariate analyses, number of chemotherapy cycles was independently predictive of PFS and OS. Patients that received <6 cycles of cisplatin had a worse PFS (HR 2.65; 95%CI 1.35–5.17; p = 0.0045) and OS (HR 4.47; 95% CI 1.83–10.9; p = 0.001). Additionally, advanced stage, longer time to RT completion, and absence of brachytherapy were associated with decreased OS and PFS (p < 0.05). Higher grade was associated with decreased PFS (p = 0.03) but not OS. Age, race, BMI, tumor size, smoking, histology, and IMRT were not statistically significant for OS or PFS. Conclusions: Number of cisplatin cycles, stage, grade, time to radiotherapy completion, and brachytherapy, are prognostic of PFS and OS in patients with cervical cancer undergoing treatment with combined cisplatin and RT. Efforts to decrease toxicity and improve compliance allowing for completion of six cycles of cisplatin may be associated with increased progression free and overall survival. No significant financial relationships to disclose.

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Endostar Rebuilding Vascular Homeostasis and Enhancing Chemotherapy Efficacy in Cervical Cancer Treatment

10.21203/rs.3.rs-61625/v1 ◽

2020 ◽

Author(s):

liming guan

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Reproductive Tract ◽

Progression Free Survival ◽

Chemotherapeutic Agents ◽

Antiangiogenic Agents ◽

Vascular Homeostasis ◽

Study Results ◽

Short Period ◽

Notch Signal Pathway

Abstract Background:The incidence rate of cervical cancer is the highest in the reproductive tract, and is not sensitive to chemotherapy. An appropriate amount of antiangiogenic agents can reconstruct tumor blood vessels in a short period of time and form vascular homeostasis, increase the function of blood vessel perfusion and reverse the multidrug resistance of chemotherapy, which is also called "vascular normalization".Endostar(a recombinant human endostatin) was developed by China and as a multi-target anti-angiogenesis agent.Endostar was mainly used in the treatment of non-small cell lung cancer, fewer reported in the treatment of cervical cancer.Purpose:To determine whether endostar can rebuild tumor vascular homeostasis and enhance chemotherapy effects for patients with cervical cancer.Methods:In this study,the patients with cervical cancer within stage IIB2 were selected,endostar combined with cisplatin+paclitaxel neoadjuvant chemotherapy(NACT) before radical surgical operation was adopted, patients outcome and adverse reaction were followed up.The changes of tumor vascular structure and perfusion function before and after endostar given were evaluated by histopathology and dynamic contrast-enhanced magnetic resonance imaging(DEC-MRI). VEGF-Notch signal pathway was detected for the regulating mechanism of vascular proliferation in different groups. GraphPad Prism 6 software were used for statistical analysis of the study results.Results:Endostar enhanced short-term (2 year) overall survival(OS) ,progression free survival(PFS) rates for cervical cancer patients.All the same,endostar increased long term (5 year) OS and PFS for cervical cancer patients.Endostar therapy exhibited with mild adverse reaction.MRI showed endostar+NACT further reduce tumor volume than NACT alone.The parameters of Ktrans,Ve for DEC-MRI in endostar group exhibited obviously increase than NACT group.Tumor vascular maturation index α-SMA/CD31 in endostar group increased obviously than NACT group, correspondingly Ki67 staining for tumor proliferative rates,lymphvascular space invasion in endostar group further declined than NACT group. The genes and proteins expression of VEGFR2,Notch1,Notch1,4,Dll4,Jagged-1 were obviously down regulated in endostar group comparing to NACT group.Conclusions: Endorstar restored vascular homeostasis in cervical cancer temporarily, enhanced chemotherapeutic agents resistance in cervical cancer, increased patient overall survival ratio.The VEGF-Notch connection blocked by endostar may play a role in this effects.

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Intensity modulated radiation therapy boost in locally-advanced cervical cancer in the absence of brachytherapy

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2019-000735 ◽

2020 ◽

Vol 30 (5) ◽

pp. 607-612 ◽

Cited By ~ 1

Author(s):

Roberta Lazzari ◽

Giulia Riva ◽

Matteo Augugliaro ◽

Andrea Vavassori ◽

Samantha Dicuonzo ◽

...

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Lymph Nodes ◽

Local Control ◽

External Beam Radiotherapy ◽

Locally Advanced ◽

Intensity Modulated Radiation Therapy ◽

Progression Free Survival ◽

External Beam ◽

Tumor Persistence

ObjectiveStandard treatment in locally-advanced cervical cancer is external beam radiotherapy concomitant with platinum-based chemotherapy, followed by brachytherapy. The goal of our study was to determine whether an intensity modulated radiation therapy (IMRT) boost is feasible in patients unfit for brachytherapy.MethodsWe retrospectively analyzed data of 25 patients unfit for brachytherapy with median age 55 years (range, 30–82) with locally-advanced/metastatic cervical cancer who underwent external beam radiotherapy to pelvis ±para-aortic lymph nodes and sequential IMRT boost between July 2014 and December 2017. Total dose of 45–50.4 Gy in 25–28 fractions (1.8 Gy/fraction) was administered to the cervix, uterus, parametria, ovaries, vaginal tissues (based on vaginal extension), involved lymph nodes, or relevant draining lymph-nodal groups. Para-aortic nodes were included if involved at radiological staging or if common iliac nodes were positive. The IMRT boost included all residual tumor after external beam radiotherapy identified on MRI. The Kaplan–Meier method was used to calculate 2 years' overall survival, 2 years' progression-free survival, and 2 years' local control. Overall survival- and progression-free survival were calculated considering the starting of radiotherapy or neo-adjuvant chemotherapy if prescribed, while local control was calculated from the end of radiotherapy.ResultsMedian radiation dose to pelvis ±para-aortic lymph nodes was 50.4 Gy (45–50.4), boost treatment was homogeneously performed to a total dose of 25 Gy in five fractions every other day.After a median follow-up of 26 months (range, 4–77), tumor persistence at cervix at 6 months from the end of radiotherapy or local recurrence occurred in five women (20%), eight (32%) experienced a further distant progression (two of them had also tumor persistence). Two-year local control and overall survival rates for all stages were 78% and 67%, respectively. According to Common Terminology Criteria for Adverse Events v.4 scoring criteria, 10 patients experienced gastrointestinal and/or genitourinary grade G1-2 acute toxicity. G2 rectal late toxicity requiring laser-coagulation was registered in two patients, there were no gastrointestinal and/or genitourinary acute or late toxicities≥G3.ConclusionThe combination of external beam radiotherapy and brachytherapy remains the standard of care, however our preliminary data show the feasibility of IMRT boost in terms of toxicity with promising results in terms of local control and overall survival.

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Neoadjuvant vascular-targeted photodynamic therapy improves survival and reduces recurrence and progression in a mouse model of urothelial cancer

Scientific Reports ◽

10.1038/s41598-021-84184-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Barak Rosenzweig ◽

Renato B. Corradi ◽

Sadna Budhu ◽

Ricardo Alvim ◽

Pedro Recabal ◽

...

Keyword(s):

Overall Survival ◽

Photodynamic Therapy ◽

Local Recurrence ◽

Therapeutic Efficacy ◽

Urothelial Cancer ◽

Locally Advanced ◽

Progression Free Survival ◽

Long Term Memory ◽

Kaplan Meier ◽

Targeted Photodynamic Therapy

AbstractLocally advanced urothelial cancer has high recurrence and progression rates following surgical treatment. This highlights the need to develop neoadjuvant strategies that are both effective and well-tolerated. We hypothesized that neoadjuvant sub-ablative vascular-targeted photodynamic therapy (sbVTP), through its immunotherapeutic mechanism, would improve survival and reduce recurrence and progression in a murine model of urothelial cancer. After urothelial tumor implantation and 17 days before surgical resection, mice received neoadjuvant sbVTP (WST11; Tookad Soluble, Steba Biotech, France). Local and systemic response and survival served as measures of therapeutic efficacy, while immunohistochemistry and flow cytometry elucidated the immunotherapeutic mechanism. Data analysis included two-sided Kaplan–Meier, Mann–Whitney, and Fischer exact tests. Tumor volume was significantly smaller in sbVTP-treated animals than in controls (135 mm3 vs. 1222 mm3, P < 0.0001) on the day of surgery. Systemic progression was significantly lower in sbVTP-treated animals (l7% vs. 30%, P < 0.01). Both median progression-free survival and overall survival were significantly greater among animals that received sbVTP and surgery than among animals that received surgery alone (P < 0.05). Neoadjuvant-treated animals also demonstrated significantly lower local recurrence. Neoadjuvant sbVTP was associated with increased early antigen-presenting cells, and subsequent improvements in long-term memory and increases in effector and active T-cells in the spleen, lungs, and blood. In summary, neoadjuvant sbVTP delayed local and systemic progression, prolonged progression-free and overall survival, and reduced local recurrence, thereby demonstrating therapeutic efficacy through an immune-mediated response. These findings strongly support its evaluation in clinical trials.

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Failure patterns and outcomes of dose escalation of stereotactic body radiotherapy for locally advanced pancreatic cancer: a multicenter cohort study

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920977155 ◽

2020 ◽

Vol 12 ◽

pp. 175883592097715

Author(s):

Xiaofei Zhu ◽

Yangsen Cao ◽

Tingshi Su ◽

Xixu Zhu ◽

Xiaoping Ju ◽

...

Keyword(s):

Pancreatic Cancer ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Progression Free Survival ◽

Locally Advanced Pancreatic Cancer ◽

Multicenter Cohort Study ◽

Failure Patterns ◽

Kaplan Meier ◽

Prescription Dose ◽

Contrast Ct

Objective: This study aims to compare recurrence patterns and outcomes of biologically effective dose (BED10, α/β = 10) of 60–70 Gy with those of a BED10 >70 Gy for locally advanced pancreatic cancer (LAPC). Methods: Patients from three centers with a biopsy and a radiographically proven LAPC were retrospectively included and data were prospectively collected from June 2012 to June 2019. Radiotherapy was delivered by stereotactic body radiation therapy. Recurrences were categorized as in-field, marginal, and outside-the-field recurrence. Patients in two groups were required to receive abdominal enhanced contrast CT or MRI every 2–3 months and CA19-9 examinations every month during follow-up. Treatment-related toxicities were evaluated every month. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method. Results: After propensity score matching, there were 486 patients in each group. The median prescription dose of the two groups was 37 Gy/5–8 f (range: 36–40.8 Gy/5–8 f) and 42 Gy/5–8 f (range: 40–49.6 Gy/5–8 f), respectively. The median OS of patients with a BED10 >70 Gy and a BED10 60–70 Gy was 20.3 months (95% CI: 19.1–21.5 months) and 18.2 months (95% CI: 17.8–18.6 months) respectively ( p < 0.001). The median PFS of the two cohorts was 15.4 months (95% CI: 14.2–16.6 months) and 13.3 months (95% CI: 12.9–13.7 months) respectively ( p < 0.001). A higher incidence of in-field and marginal recurrence was found in patients with BED10 of 60–70 Gy (in-field: 97/486 versus 72/486, p = 0.034; marginal: 109/486 versus 84/486, p = 0.044). However, more patients with BED10 >70 Gy had grade 2 or 3 acute (87/486 versus 64/486, p = 0.042) and late gastrointestinal toxicities (77/486 versus 55/486, p = 0.039) than those with BED10 of 60–70 Gy. Conclusion: BED10 >70 Gy was found to have the best survival benefits along with a higher incidence of acute and late gastrointestinal toxicities. Therefore, a higher dose may be required in the case of patients’ good tolerance.

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637 Immune-related adverse events (irAEs) may indicate a favorable prognosis in metastatic renal cell carcinoma (mRCC) patients treated with immune checkpoint inhibitors (ICI)

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-sitc2020.0637 ◽

2020 ◽

Vol 8 (Suppl 3) ◽

pp. A672-A673

Author(s):

Dylan Martini ◽

Sean Evans ◽

Subir Goyal ◽

Yuan Liu ◽

T Anders Olsen ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Overall Survival ◽

Adverse Events ◽

Clinical Outcomes ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Progression Free Survival ◽

Free Survival ◽

Kaplan Meier ◽

Emory University

BackgroundImmune checkpoint inhibitors (ICI) have become an increasingly utilized treatment in metastatic renal cell carcinoma (mRCC). Although they have a favorable toxicity profile, immune-related adverse events (irAEs) can have a significant impact on patients‘ quality of life. It is not well understood whether irAEs are associated with improved clinical outcomes. We investigated the relationship between irAEs and clinical outcomes in mRCC patients treated with ICI.MethodsWe performed a retrospective study of 200 patients with mRCC who received ICI at Winship Cancer Institute of Emory University from 2015–2020. Clinical outcomes were measured by overall survival (OS), progression-free survival (PFS), and clinical benefit (CB). OS and PFS were calculated from ICI-initiation to date of death and radiographic or clinical progression, respectively. CB was defined as a best radiographic response of complete response (CR), partial response (PR), or stable disease (SD) for >6 months per response evaluation criteria in solid tumors (RECIST) version 1.1. Toxicity data was collected from clinic notes and laboratory values. The association with OS and PFS was modeled by Cox proportional hazards model. Kaplan-Meier curves were created for survival estimates.ResultsMost patients were males (71%), and 78% had clear-cell RCC (ccRCC). Most patients (58%) received anti-PD-1 monotherapy. The majority were international mRCC database consortium (IMDC) intermediate (57%) or poor-risk (26%). Anti-PD-1 monotherapy was the most common (58%) treatment regimen and most patients received ICI as first (38%) or second-line (42%) treatment. One-third of patients (33%) experienced an irAE, with the most common being endocrine (13%), gastrointestinal (11%), and dermatologic (10%). Patients who experienced irAEs had significantly longer OS (HR: 0.52, 95% CI: 0.32–0.87, p=0.013), higher chance of CB (OR: 2.10, 95% CI: 1.11–4.00, p=0.023) and showed a trend towards longer PFS (HR: 0.71, 95% CI: 0.49–1.02, p=0.065) in MVA (table 1). Patients who had thyroid irAEs had significantly longer OS, PFS, and higher chance of CB in MVA (table 1). The objective response rate was higher for patients who experienced irAEs (34% vs. 18%). Patients who experienced irAEs had significantly longer median OS (44.5 vs. 18.2 months, p=0.005) and PFS (7.5 vs 3.6 months, p=0.0028) compared to patients who did not (figure 1).Abstract 637 Table 1MVA* of association between irAEs and clinical outcomesAbstract 637 Figure 1Kaplan-Meier curves of association between immune-related adverse events (irAEs) and overall survival (OS, top panel) and progression-free survival (PFS, bottom panel)ConclusionsWe showed that mRCC patients who experienced irAEs, particularly thyroid irAEs, had improved clinical outcomes. This suggests that irAEs may be prognostic of favorable outcomes in mRCC patients treated with ICI. Larger, prospective studies are needed to validate these findings.AcknowledgementsResearch reported in this publication was supported in part by the Breen Foundation and the Biostatistics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Trial RegistrationNot applicableEthics ApprovalThis retrospective study was approved by the Emory University Institutional Review Board.ConsentNot applicableReferencesNot applicable

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651 A META-ANALYSIS OF SURVIVAL AFTER NEOADJUVANT CHEMORADIOTHERAPY VERSUS NEOADJUVANT CHEMOTHERAPY IN RESECTABLE LOCALLY ADVANCED ESOPHAGEAL CANCERS BASED ON HISTOLOGIC SUBTYPES

Diseases of the Esophagus ◽

10.1093/dote/doab052.651 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Rawat Waratchanont ◽

Jirat Leelapatanadit ◽

Wichitra Asanprakit ◽

Viriya Kaewkangsadan ◽

Sukchai Sattaporn

Keyword(s):

Overall Survival ◽

Postoperative Complications ◽

Neoadjuvant Chemotherapy ◽

Meta Analysis ◽

Locally Advanced ◽

Neoadjuvant Chemoradiotherapy ◽

Progression Free Survival ◽

Comprehensive Search ◽

Complications And Mortality ◽

Histologic Subtypes

Abstract Neoadjuvant treatments provided survival benefits over surgery alone in resectable locally advanced esophageal and esophagogastric junction (EGJ) cancer patients. Both neoadjuvant chemoradiotherapy (nCRT) and neoadjuvant chemotherapy (nCT) are shown to be effective treatments. However, the direct comparison between two methods based on histologic subtypes, squamous cell carcinoma (SCC) and adenocarcinoma (AC) is still limited. This study examined the hypothesis that nCRT could provide the better overall survival (OS) than nCT. Methods A comprehensive search of studies comparing nCRT and nCT in patients with esophageal and EGJ cancer based on histologic subtypes was conducted. A meta-analysis of randomized (8 articles) and non-randomized (15 articles) studies was performed using odds ratio (OR) and 95% confidence intervals (CI95%). The OS was the main objective, whereas the secondary objective were complete pathological response (pCR) rate, curative resection (R0) rate, locoregional progression free-survival (L-PFS) rate, postoperative complications and mortality. Results Twenty three articles included 1,671 SCC and 9,285 AC patients. Neither 3- nor 5-year OS was found to be different. However, SCC patients receiving nCRT showed the better 3-year OS (OR 1.67, CI95% 1.17–2.40, p = 0.005). Both pCR and R0 rates were superior in nCRT group (OR 3.30, CI95% 2.46–4.44 and 2.46, CI95% 1.66–3.65, p < 0.00001, respectively). The better 3-year L-PFS was observed in nCRT group (OR 1.47, CI95% 1.17–1.85, p = 0.008), but 5-year L-PFS was comparable. The 30-day mortality was comparable, while 90-day mortality was higher in nCRT group (OR 1.32, CI95% 1.01–1.72, p = 0.04). Conclusion The nCRT provided the better overall survival especially in SCC patients and also increased locoregional control. Meanwhile, postoperative complications and mortality were higher after nCRT. Due to clinical heterogeneity, the multidisciplinary team management for each patient is required before treatment.

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Trends in glassy cell cervical cancer in the United States from 1973-2015: Analysis based on SEER database.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e17502 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e17502-e17502

Author(s):

Anahat Kaur ◽

Shuai Wang ◽

Tarek N. Elrafei ◽

Lewis Steinberg ◽

Abhishek Kumar

Keyword(s):

United States ◽

Cervical Cancer ◽

Overall Survival ◽

Cell Carcinoma ◽

Small Sample Size ◽

Black Population ◽

The United States ◽

Small Sample ◽

Cervix Uteri ◽

Kaplan Meier

e17502 Background: Glassy cell carcinoma of cervix (GCCC) is a rare histological subtype of cervical cancer which has historically been associated with rapidly progressive disease, early development of metastases and overall poor prognosis. We attempt to define real-world trends in GCCC in the United States based on data from SEER (Surveillance, Epidemiology and End Results) database. Methods: We extracted data from the US National Cancer Institute's SEER 2018 dataset using ICD-O code for ‘Cervix Uteri Glassy Cell Carcinoma’. All patients who were diagnosed between 1973-2015 were included. Statistical analysis was done using SPSS 26. Kaplan Meier curve was used for survival analysis. Results: Data for a total of 57 patients with GCCC was available from 1975 to 2017. Median age at diagnosis was 38 years (range 30.5-44.5). Increased frequency of cases was noted in white females (77.2%) as compared to black population (22.2%). Most cases initially presented with localized or regional spread (47.4% and 40.4% respectively) with distant metastasis seen in only 10.5% patients. Data analysis revealed that 63.2% patients had Grade III poorly differentiated carcinoma, 66.7% received radiation therapy, 57.9% underwent chemotherapy and 59.6% had cancer direceted surgery performed. Calculated mean overall survival was 121.9 months. We were unable to calculate 5 year and 10 year median overall survival due to small sample size and censored data. Conclusions: GCCC is a rare histologic type of cervical cancer that presents at a younger age, is more frequently seen in white females and is commonly associated with localized or regional spread at time of initial presentation.[Table: see text]

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Clinical outcome and side effects of concomitant chemoradiotherapy in the treatment of locally advanced inoperable non-small cell lung cancer: Our experiences

Vojnosanitetski pregled ◽

10.2298/vsp210102038r ◽

2021 ◽

pp. 38-38

Author(s):

Bojan Radojicic ◽

Marija Radojicic ◽

Miroslav Misovic ◽

Dejan Kostic

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Locally Advanced ◽

Progression Free Survival ◽

Small Cell ◽

Small Cell Lung ◽

Concomitant Chemoradiotherapy ◽

Free Survival

Background/Aim. About 1.8 million new lung cancer cases are diagnosed in the world every year, and about 1.6 million cases are with fatal outcome. Despite improvements in treatment in previous decades, the survival of patients with lung cancer is still poor. The five-year survival rate is about 50% for patients with localized disease, 20% for patients with regionally advanced disease, 2% for patients with metastatic disease, and about 14% for all stages. The median survival of patients with untreated NSCLC in the advanced stage is four to five months and the annual survival rate is only 10%. The main goal of the research is to obtain and analyze the results of treatment with concomitant chemotherapy in terms of its efficacy and toxicity in selected patients with locally advanced inoperable non-small cell lung cancer. Methods. The study included data analysis of 31 patients of both sexes who were diagnosed and pathohistologically verified with NSCLC in inoperable stage III and were referred by the Council for Malignant Lung Diseases to the Radiotherapy Department of the Military Medical Academy for concomitant chemoradiotherapy treatment. Upon expiry of the three-month period from the performed radiation treatment, the tumor resonance was assessed on the basis of MSCT examination of the chest and upper abdomen according to RECIST 1.1 criteria (Response Evaluation Criteria in Solid Tumors). According to the same criteria, progression-free survival (PFS) was also assessed every three months during the first two years, then every 6 months or until the onset of disease symptoms, as well as overall survival (OS). Result. The median progression-free survival is 13 months, and the median overall survival is 20 months. During and immediately after RT, 9 (29%) patients had a grade 2 or higher adverse event. Conclusion. The use of concomitant chemoradiotherapy in patients in the third stage of locally advanced inoperable non-small cell lung cancer provides a good opportunity for a favorable therapeutic outcome, with an acceptable degree of acute and late toxicity, and represents the standard therapeutic approach for selected patients in this stage of the disease.

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