Predicting tumor recurrence in patients with cervical carcinoma treated with definitive chemoradiotherapy: value of quantitative histogram analysis on diffusion-weighted MR images

2016 ◽  
Vol 58 (4) ◽  
pp. 481-488 ◽  
Author(s):  
Gurcan Erbay ◽  
Cem Onal ◽  
Elif Karadeli ◽  
Ozan C Guler ◽  
Sami Arica ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Tumor Recurrence ◽  
Disease Recurrence ◽  
Definitive Chemoradiotherapy ◽  
Node Metastasis ◽  
The Mean

Background Further research is required for evaluating the use of ADC histogram analysis in more advanced stages of cervical cancer treated with definitive chemoradiotherapy (CRT). Purpose To investigate the utility of apparent diffusion coefficient (ADC) histogram derived from diffusion-weighted magnetic resonance images in cervical cancer patients treated with definitive CRT. Material and Methods The clinical and radiological data of 50 patients with histologically proven cervical squamous cell carcinoma treated with definitive CRT were retrospectively analyzed. The impact of clinicopathological factors and ADC histogram parameters on prognostic factors and treatment outcomes was assessed. Results The mean and median ADC values for the cohort were 1.043 ± 0.135 × 10−3 mm2/s and 1.018 × 10−3 mm2/s (range, 0.787–1.443 × 10−3 mm2/s). The mean ADC was significantly lower for patients with advanced stage (≥IIB) or lymph node metastasis compared with patients with stage <IIB or no lymph node metastasis. The mean ADC, 75th percentile ADC (ADC75), 90th percentile ADC (ADC90), and 95th percentile ADC (ADC95) were significantly lower in patients with tumor recurrence compared with patients without recurrence. In multivariate analysis, tumor size, ADC75 and ADC95 were independent prognostic factors for both overall survival and disease-free survival. Conclusion ADC histogram parameters could be markers for disease recurrence and for predicting survival outcomes. ADC75, ADC90, and ADC95 of the primary tumor were significant predictors of disease recurrence in cervical cancer patients treated with definitive CRT.

Primary Treatment and Prognostic Factors of Carcinosarcoma of the Ovary, Fallopian Tube, and Peritoneum: A Taiwanese Gynecologic Oncology Group Study

2014 ◽  
Vol 24 (3) ◽  
pp. 506-512 ◽  
Author(s):  
Chien-Hsing Lu ◽  
I-Hui Chen ◽  
Yi-Jen Chen ◽  
Kung-Liahng Wang ◽  
Jian-Tai Timothy Qiu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Fallopian Tube ◽  
Gynecologic Oncology ◽  
Gynecologic Oncology Group ◽  
Oncology Group ◽  
Node Metastasis ◽  
The Mean

ObjectiveThis study aimed to determine the clinical prognostic factors involved in carcinosarcoma of the ovary, fallopian tube, and peritoneum.Materials and MethodsThis retrospective study was undertaken by the Taiwanese Gynecologic Oncology Group. The retrieved clinical data included demographic characteristics, medical disease, tumor status, extent of surgery, and adjuvant chemotherapy.ResultsIn total, 63 patients with carcinosarcoma of the ovary, fallopian tube, and peritoneum were identified. Sixty-one patients with complete data were enrolled for further data analysis. The mean follow-up period was 1.0 year, and the mean overall survival was 15.4 months. By log-rank tests, age, menopausal status, parity, hypertension, diabetes, primary tumor size, para-aortic lymph node metastasis, pretreatment CA-125, preceding diagnostic surgery, hysterectomy, lymphadenectomy, other surgeries, and paclitaxel use were not predictive of overall survival.Omentectomy, no gross residual implants after surgery, platinum treatment, and no pelvic lymph node metastasis had a trend toward better survival. Early diagnosis at stage I and cisplatin/ifosfamide regimen were significant associated with a better overall survival in log-rank and simple Cox regression tests. Bilateral ovarian tumors and metastatic tumors larger than 2 cm were significantly associated with a poorer overall survival.ConclusionsEarly diagnosis at stage I, unilateral ovarian tumor, metastatic tumors less than 2 cm, and cisplatin/ifosfamide regimen were predictive of a better survival.Omentectomy and complete debulking surgery also showed a trend toward better survival. Thus, these treatment strategies should be applied in patients with carcinosarcoma of the ovary, fallopian tube, and peritoneum.

scholarly journals Sentinel Lymph Node Biopsy Is Feasible in Cervical Cancer Laparoscopic Surgery: A Single-Center Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hongyi Hou ◽  
Yibo Dai ◽  
Sichen Liang ◽  
Zhiqi Wang ◽  
Jianliu Wang
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Sentinel Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Clinical Application ◽  
Related Factors ◽  
Detection Rates ◽  
Node Metastasis

Background and Objective. Sentinel lymph node (SLN) biopsy efficiency has been confirmed in various solid tumors. This study aimed to assess SLN biopsy feasibility in clinical application and explore how to improve its detection rates and diagnostic accuracy in cervical cancer laparoscopic surgery. Methods. A total of 100 cervical cancer patients undergoing laparoscopic surgery with SLN biopsy were included. Indocyanine green, carbon nanoparticles (CNPs), and a combination of both were used during surgeries. Detection rates, sensitivity, negative predictive value (NPV) of SLN biopsy, and related factors were analyzed. Results. The overall and bilateral SLN detection rates were 92% (92/100) and 74% (74/100), respectively. Combined tracers had higher bilateral SLN detection rates than CNPs alone ( p = 0.005 ). Menopause and lymph node metastasis were associated with lower overall and bilateral SLN detection rates ( p < 0.05 ). SLN biopsy sensitivity and NPV for lymph node metastasis in patients with at least one detected SLN were 81.8% (9/11) and 97.3% (72/74), respectively. Among those with bilateral detected SLNs, higher sensitivity and NPV of 87.5% (7/8) and 98.3% (57/58) were observed, respectively. SLN algorithm can ensure that all patients with lymph node metastasis are detected by SLN biopsy. Conclusion. SLN biopsy appears to be safe and effective for specific cervical cancer patients with high detection rates and NPV in laparoscopic surgery, especially for those with detected bilateral SLNs and undergoing the SLN algorithm. Selecting suitable patients for SLN mapping has prospects for clinical application.

Prognostic Use of Pretreatment Hematologic Parameters in Patients Receiving Definitive Chemoradiotherapy for Cervical Cancer

2016 ◽  
Vol 26 (6) ◽  
pp. 1169-1175 ◽  
Author(s):  
Cem Onal ◽  
Ozan C. Guler ◽  
Berna A. Yildirim
Keyword(s):  
Cervical Cancer ◽  
Multivariate Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Univariate Analysis ◽  
Definitive Chemoradiotherapy ◽  
Lymphocyte Ratio ◽  
Node Metastasis ◽  
Cell Counts ◽  
Potential Biomarker

ObjectivesThe aim of this work was to evaluate the prognostic role of pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in recipients of definitive chemoradiotherapy (ChRT) for cervical cancer.MethodsIn 235 patients given definitive ChRT for histologically confirmed cervical cancer, clinical data and pretreatment complete blood cell counts were analyzed. Prognostic and therapeutic ramifications of NLR and PLR were assessed.ResultsMedian pretreatment NLR and PLR were 3.03 (range, 1.04–13.03) and 133.02 (range, 36.3–518.16), respectively. Both NLR and PLR correlated significantly with tumor size, lymph node metastasis, and treatment response. In addition to NLR and PLR, tumor stage, size, and nodal metastasis were identified by univariate analysis as significant predictors of overall survival (OS) and progression-free survival (PFS). By multivariate analysis, independent predictors of OS and PFS were NLR (OS: hazard ratio [HR], 3.322; 95% confidence interval [CI], 1.905–5.790; PFS: HR, 3.579; 95% CI, 2.106–6.082; both P < 0.001) and lymph node metastasis (OS: HR, 2.620; 95% CI, 1.706–4.023; PFS: HR, 2.989; 95% CI, 1.918–4.378; both P < 0.001), although patients’ age (HR, 1.019; 95% CI, 1.003–1.035; P = 0.02) was also significantly predictive of OS.ConclusionsPretreatment NLR and PLR were associated with larger tumors, lymph node metastasis, and poorer therapeutic responses to definitive ChRT. By multivariate analysis, pretreatment NLR and lymph node metastasis were found independently predictive of OS and PFS, whereas patients’ age was significantly predictive of OS only. In patients with advanced cervical cancer, NLR is a potential biomarker, serving to guide systemic therapy and predict treatment outcomes.

scholarly journals Breast Cancer in Chinese Females Aged 25 Years and Younger

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Lixi Li ◽  
Dan Lv ◽  
Jingtong Zhai ◽  
Di Zhang ◽  
Xiuwen Guan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Lymphovascular Invasion ◽  
Clinicopathological Characteristics ◽  
Breast Cancer Patients ◽  
Young Females ◽  
Node Metastasis

Background. Breast cancer has both aggressive clinicopathological characteristics and a poor prognosis in young females. However, limited information is available for breast cancer in Chinese females aged ≤25 years. Therefore, we aimed to explore prognostic factors for invasive disease-free (iDFS) and overall survival (OS) among breast cancer patients aged ≤25 years. Methods. We retrospectively analyzed data from 174 Chinese females aged ≤25 years with invasive breast cancer treated in the Cancer Hospital of the Chinese Academy of Medical Sciences from January 1, 1999, to December 31, 2018. Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors. Results. The median follow-up time was 75 months (ranging from 1 to 236 months). Breast cancer patients aged ≤25 years exhibited aggressive clinicopathological characteristics, including advanced tumor stage (21.8%), lymph node metastasis (47.1%), lymphovascular invasion (24.1%), estrogen receptor negativity (44.3%), progesterone receptor (PR) negativity (42.5%), and triple-negative breast cancer (25.3%). Among them, 50 cases had locoregional recurrence and metastasis, 20 had bilateral invasiveness, and 33 had breast cancer-specific deaths. Cox multivariate analysis identified that diagnosis delay, PR status, and radiotherapy were significant prognostic factors for both iDFS and OS ( P < 0.05 ). The risk of recurrence and metastasis was five times higher in N3 than in N0 (HR: 6.778, 95% CI: 2.268–17.141, P < 0.001 ). Patients with lymphovascular invasion had a threefold increase in the risk of breast cancer-specific death (HR: 4.217, 95% CI: 1.956–9.090, P < 0.001 ). No differences were observed between mastectomy and breast-conserving surgery (BCS) plus radiotherapy for iDFS or OS (iDFS: χ2 = 0.678, P = 0.410 ; OS: χ2 = 0.165, P = 0.685 ). Conclusions. Breast cancer in females ≤25 years old was associated with aggressive clinical features and a worse prognosis. Young females with breast lumps should receive timely diagnosis and treatment. Young breast cancer patients with lymphovascular invasion, PR-negative status, and lymph node metastasis have an increased risk of experiencing recurrence and metastasis and should hence be closely monitored. Age at diagnosis should not be the sole deciding factor for surgical treatment methods.

Can We Define the Risk of Lymph Node Metastasis in Early-Stage Cervical Cancer Patients? A Large-Scale, Retrospective Study

2017 ◽  
Vol 24 (8) ◽  
pp. 2311-2318 ◽  
Author(s):  
Gabriella Ferrandina ◽  
Luigi Pedone Anchora ◽  
Valerio Gallotta ◽  
Anna Fagotti ◽  
Enrico Vizza ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Retrospective Study ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Large Scale ◽  
Early Stage ◽  
Node Metastasis ◽  
Early Stage Cervical Cancer
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