Utilization of Diagnostic Studies in the Pretreatment Evaluation of Invasive Cervical Cancer in the United States: Results of Intergroup Protocol ACRIN 6651/GOG 183

2005 ◽  
Vol 23 (30) ◽  
pp. 7454-7459 ◽  
Author(s):  
Marco A. Amendola ◽  
Hedvig Hricak ◽  
Donald G. Mitchell ◽  
Bradley Snyder ◽  
Dennis S. Chi ◽  
...  
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Data Analysis ◽  
Diagnostic Tests ◽  
Gynecologic Oncology ◽  
Invasive Cervical Cancer ◽  
The United States ◽  
Patterns Of Care ◽  
Clinical Staging ◽  
Gynecologic Oncology Group

Purpose To review the current utilization of diagnostic tests prescribed by the International Federation of Gynecology and Obstetrics (FIGO) clinical staging guidelines in the pretreatment work-up of invasive cervical cancer, and to compare the data with those of previous patterns of care studies. Patients and Methods This interdisciplinary American College of Radiology Imaging Network/Gynecologic Oncology Group prospective clinical trial was conducted between March 1, 2000, and November 11, 2002. Twenty-five participating institutions, all from the United States, enrolled a total of 208 patients. Only patients scheduled for surgery with biopsy-confirmed cervical cancer of clinical FIGO stage IB or higher were eligible. The patterns of care data analysis was based on 197 patients who met all inclusion criteria. The conventional FIGO-recommended tests used for pre-enrollment FIGO clinical stage classification were at the discretion of the treating physician; overall frequency of use was tabulated for each test. Results Use of cystoscopy (8.1%) and sigmoidoscopy or proctoscopy (8.6%) was significantly lower than in 1988 to 1989 (P < .0001 in each instance). Intravenous urography was used in only 1% of patients as compared with 42% in 1988 to 1989 and 91% in 1983. No patient included in the data analysis had barium enema or lymphangiography. Only 26.9% of patients had examination under anesthesia for FIGO clinical staging. Conclusion There is a large discrepancy between the diagnostic tests recommended by FIGO and the actual tests used for cervical cancer staging, suggesting a need to reassess the relevance of the FIGO guidelines to current clinical practice in the United States.

Role of Imaging in Pretreatment Evaluation of Early Invasive Cervical Cancer: Results of the Intergroup Study American College of Radiology Imaging Network 6651–Gynecologic Oncology Group 183

2005 ◽  
Vol 23 (36) ◽  
pp. 9329-9337 ◽  
Author(s):  
Hedvig Hricak ◽  
Constantine Gatsonis ◽  
Dennis S. Chi ◽  
Marco A. Amendola ◽  
Kathy Brandt ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Characteristic Curve ◽  
Gynecologic Oncology ◽  
Invasive Cervical Cancer ◽  
Clinical Staging ◽  
Gynecologic Oncology Group ◽  
Reference Standard ◽  
Oncology Group ◽  
Gynecology And Obstetrics ◽  
Ct And Mri

Purpose To compare magnetic resonance imaging (MRI) and computed tomography (CT) with each other and to International Federation of Gynecology and Obstetrics (FIGO) clinical staging in the pretreatment evaluation of early invasive cervical cancer, using surgicopathologic findings as the reference standard. Patients and Methods This prospective multicenter clinical study was conducted by the American College of Radiology Imaging Network and the Gynecologic Oncology Group from March 2000 to November 2002; 25 United States health centers enrolled 208 consecutive patients with biopsy-confirmed cervical cancer of FIGO stage ≥ IB who were scheduled for surgery based on clinical assessment. Patients underwent FIGO clinical staging, helical CT, and MRI. Surgicopathologic findings constituted the reference standard for statistical analysis. Results Complete data were available for 172 patients; surgicopathologic findings were consistent with FIGO stages IA to IIA in 76% and stage ≥ IIB in 21%. For the detection of advanced stage (≥ IIB), sensitivity was poor for FIGO clinical staging (29%), CT (42%), and MRI (53%); specificity was 99% for FIGO clinical staging, 82% for CT, and 74% for MRI; and negative predictive value was 84% for FIGO clinical staging, 84% for CT, and 85% for MRI. MRI (area under the receiver operating characteristic curve [AUC], 0.88) was significantly better than CT (AUC, 0.73) for detecting cervical tumors (P = .014). For 85% of patients, FIGO clinical staging forms were submitted after MRI and/or CT was performed. Conclusion CT and MRI performed similarly; both had lower staging accuracy than in prior single-institution studies. Accuracy of FIGO clinical staging was higher than previously reported. The temporal data suggest that FIGO clinical staging was influenced by CT and MRI findings.

Patterns of care for FIGO stage IB-IIA cervical cancer across the United States

2017 ◽  
Vol 145 ◽  
pp. 181
Author(s):  
E. Pereira ◽  
N. Nair ◽  
M.A. Schwartz ◽  
J. Gorski ◽  
P. Dottino ◽  
...  
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Figo Stage ◽  
The United States ◽  
Patterns Of Care ◽  
Stage Ib

scholarly journals Patterns of care for women with cervical cancer in the United States

Cancer ◽  
2008 ◽  
Vol 113 (4) ◽  
pp. 743-749 ◽  
Author(s):  
Edward L. Trimble ◽  
Linda C. Harlan ◽  
David Gius ◽  
Jennifer Stevens ◽  
Stephen M. Schwartz
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
The United States ◽  
Patterns Of Care

DIET AND THE RISK OF INVASIVE CERVICAL CANCER AMONG WHITE WOMEN IN THE UNITED STATES

1990 ◽  
Vol 132 (3) ◽  
pp. 432-445 ◽  
Author(s):  
REGINA G. ZIEGLER ◽  
LOUISE A. BRINTON ◽  
RICHARD F. HAMMAN ◽  
HERMAN F. LEHMAN ◽  
ROBERT S. LEVINE ◽  
...  
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
White Women ◽  
Invasive Cervical Cancer ◽  
The United States

Impact of NCI Clinical Announcement upon use of chemoradiation for women with cervical cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5537-5537 ◽  
Author(s):  
E. L. Trimble ◽  
D. Gius ◽  
L. C. Harlan
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Invasive Cervical Cancer ◽  
The United States ◽  
Initial Therapy ◽  
Population Based ◽  
Phase Iii ◽  
Younger Women ◽  
Platinum Based Chemotherapy ◽  
To Receive

5537 Background: On the basis of 5 NCI-sponsored randomized phase III trials, in 1999 the NCI issued a Clinical Announcement recommending that women with cervical cancer who require radiation also receive concomitant platinum-based chemotherapy. We undertook a population-based cohort study to determine whether the 1999 NCI Clinical Announcement was associated with changes in clinical practice in the United States. Methods: Through the NCI’s SEER program, we identified 973 women with invasive cervical cancer diagnosed in 1997, 773 diagnosed in 2000, and 1370 diagnosed in 2001. Hospital records were re-abstracted and treated physicians were contacted to verify initial therapy provided to each patient. Results: In multivariate analysis, we found a significant increase in the use of chemoradiation between 1997 and 2001/2001 among women with cervical cancer of all stages for which radiation would be appropriate. (see table ). Compared to women with well-differentiated tumors, women with moderately or poorly differentiated tumors were more likely to receive chemoradiation. Women aged 75 years or older were significantly less likely to receive chemoradiation than younger women. We saw no impact of race/ ethnicity or insurance status upon receipt of chemoradiation. Conclusions: Publication of the results from these 5 sutdies, extensive professional educational efforts, and the NCI’s Clinical Announcement were associated with widespread adoption of chemotherapy in the treatment of cervical cancer in the United States. [Table: see text] No significant financial relationships to disclose.

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