The effects of body mass index on curative radiation therapy in cervical carcinoma: An analysis of complications and survival

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16520-e16520
Author(s):  
P. H. Thaker ◽  
F. Gao ◽  
I. Zighelboim ◽  
M. A. Powell ◽  
J. S. Rader ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cervical Cancer ◽  
Overall Survival ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Body Mass ◽  
Disease Free Survival ◽  
Free Survival ◽  
Underweight Patients ◽  
Disease Free

e16520 Background: Recently, the rates of obese and overweight patients have increased dramatically. However, the effect of body mass index (BMI) have not been evaluated in treatment outcomes for patients with advanced stage cervical cancer receiving definitive chemotherapy and radiation therapy, and is the purpose of this study. Methods: After obtaining approval from the Washington University Human Studies Protection Office, a retrospective cohort study (n = 321) was performed on all cervical cancer patients with stage IB1 with positive lymph nodes or ≥ stage IB2 from January 1998 to January 2008. The median duration of follow up was 60 months. BMI was calculated using the National Institute of Health online BMI calculator. Main outcomes were overall survival, disease free survival, and radiation complications such as radiation enteritis/cystitis, bowel obstruction, and fistula formation. Univariate and multivariate analyses were performed, and Kaplan-Meier curves were generated. Results: Underweight patients (BMI<18.5 kg/m2) compared to normal weight (BMI = 18.5–25 kg/m2) and overweight/obese (>25 kg/m2) have a higher actuarial complication rate (p = 0.0137). Regardless of weight there is no difference in disease free survival. However, underweight patients have a significantly poorer overall survival than those patients with a higher BMI (>18.5 kg/m2) (p < 0.001). Conclusions: Underweight patients have a diminished overall survival compared to normal or obese cervical cancer patients. This is of clinical relevance when counseling underweight cervical cancer patients who will be cured of the disease with chemotherapy and radiation therapy, but have a significant risk of suffering potentially fatal complications from treatment. Further study needs to be done to elucidate this relationship further. No significant financial relationships to disclose.

Radical hysterectomy in early cervical cancer in Europe: characteristics, outcomes and evaluation of ESGO quality indicators

2021 ◽  
pp. ijgc-2021-002587
Author(s):  
Felix Boria ◽  
Luis Chiva ◽  
Vanna Zanagnolo ◽  
Denis Querleu ◽  
Nerea Martin-Calvo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Quality Indicators ◽  
Radical Hysterectomy ◽  
Disease Free Survival ◽  
Free Survival ◽  
Operative Complications ◽  
Early Cervical Cancer ◽  
Disease Free

IntroductionComprehensive updated information on cervical cancer surgical treatment in Europe is scarce.ObjectiveTo evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database.MethodsThe SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified.ResultsThe mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0–84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation.ConclusionsIn this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations.

Neutrophil-lymphocyte index as prognostic factor for overall survival and disease-free survival in breast cancer patients

2020 ◽  
Vol 33 (4) ◽  
pp. 137-144
Author(s):  
Guillermo Peralta-Castillo ◽  
Antonio Maffuz-Aziz ◽  
Mariana Sierra-Murguía ◽  
Sergio Rodriguez-Cuevas
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Disease Free

Correlation between outcomes and tumor size in >7 cm T4 non-small cell lung cancer patients: A tumor size-based comparison study

2021 ◽  
Vol 29 (8) ◽  
pp. 784-791
Author(s):  
Volkan Erdoğu ◽  
Necati Çitak ◽  
Celal B Sezen ◽  
Levent Cansever ◽  
Cemal Aker ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Tumor Size ◽  
Disease Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Free Survival ◽  
Lung Cancer Patients ◽  
Disease Free

Background We investigated whether all size-based pathological T4N0–N1 non-small cell lung cancer patients with tumors at any size >7 cm had the same outcomes. Methods We reviewed non-small cell lung cancer patients with tumors >7 cm who underwent anatomical lung resection between 2010 and 2016. A total of 251 size-based T4N0–N1 patients were divided into two groups based on tumor size. Group S ( n = 192) included patients with tumors of 7.1–9.9 cm and Group L ( n = 59) as tumor size ≥10 cm. Results The mean tumor size was 8.83 ± 1.7 cm (Group S: 8.06 ± 0.6 cm, Group L: 11.3 ± 1.6 cm). There were 146 patients with pathological N0 and 105 patients with pathological N1 disease. Mean overall survival and disease-free survival were 64.2 and 51.4 months, respectively. The five-year overall survival and disease-free survival rates were 51.2% and 43.5% (five-year OS; pT4N0:52.7%, pT4N1:47.9%, DFS; pT4N0:44.3%, pT4N1: 42.3%). No significant differences were observed between T4N0 and T4N1 patients in terms of five-year OS or DFS ( p = 0.325, p = 0.505 respectively). The five-year overall survival and disease-free survival rates were 52% and 44.6% in Group S, and 48.5% and 38.9% in Group L. No significant difference was observed between the groups in terms of five-year overall survival or disease-free survival ( p = 0.699, p = 0.608, respectively). Conclusions Above 7 cm, any further increase in tumor size in non-small cell lung cancer patients had no significant effect on survival, confirming it is not necessary to further discriminate among patients with tumors in that size class.

Burden of lymphatic disease predicts efficacy of adjuvant radiation and chemotherapy in FIGO 2018 stage IIICp cervical cancer

2019 ◽  
Vol 29 (9) ◽  
pp. 1355-1360 ◽  
Author(s):  
Giorgio Bogani ◽  
Daniele Vinti ◽  
Ferdinando Murgia ◽  
Valentina Chiappa ◽  
Umberto Leone Roberti Maggiore ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Rank Test ◽  
Survival Outcomes ◽  
Adjuvant Radiation ◽  
Free Survival ◽  
Log Rank Test ◽  
Disease Free ◽  
Positive Lymph Nodes

ObjectiveNodal involvement is one of the most important prognostic factors in cervical cancer patients. We aimed to assess the prognostic role in relation to the burden of nodal disease in stage IIICp cervical cancer.MethodsData on all consecutive patients diagnosed with cervical cancer undergoing primary surgery (radical hysterectomy plus lymphadenectomy) or neoadjuvant chemotherapy followed by radical hysterectomy plus lymphadenectomy, between January 1980 and December 2017, were collected in a dedicated database. Exclusion criteria were: (1) consent withdrawal; (2) synchronous malignancies (within 5 years). Survival outcomes were assessed using Kaplan-Meier and Cox models.ResultsOverall, 177 (14.1%) of 1257 patients with cervical cancer were diagnosed with positive lymph nodes. After a median follow-up of 58 (range 4–175) months, 66 (37.3%) and 37 (20.9%) patients developed recurrent disease and died of disease, respectively. Via multivariate analysis, positive para-aortic nodes (HR 2.62, 95% CI 1.12 to 6.11; p=0.025) and the number of positive nodes (HR 1.06, 95% CI 1.02 to 1.11; p=0.002) correlated with worse disease-free survival. Furthermore, the number of positive nodes (HR 1.06, 95% CI 1.01 to 1.12; p=0.021) correlated with worse overall survival. Number of positive nodes (1, 2 or ≥3) strongly correlated with both disease-free survival (p<0.001, log-rank test) and overall survival (p=0.001, log-rank test). Focusing on patients receiving adjuvant radiation and chemotherapy, the number of positive lymph nodes was associated with response to treatment (p<0.001). Median disease-free survival was 100, 42, and 12 months for patients with one, two, or three or more positive lymph node(s), respectively (p<0.001, log-rank test).ConclusionsIn stage IIICp cervical cancer, adjuvant radiation and chemotherapy provides adequate overall survival in patients diagnosed with only one metastatic node, while survival outcomes are poor in patients with two or more metastatic nodes. This highlights the need for innovative treatments in patients with a high burden of lymphatic disease.

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