scholarly journals Is Tumor Size a Predictor of Survival in Stage IIA Cervical Cancer? A Comparison Between the Old and the New FIGO Staging Criteria

Author(s):  
Yong Lim ◽  
Hui Chin ◽  
Xiao Lin ◽  
Kwai Yam ◽  
Yin Chia ◽  
...  
2021 ◽  
Vol 5 (1) ◽  
pp. 002-005
Author(s):  
Soderini Alejandro ◽  
Aragona Alejandro ◽  
Quintaie Agustin ◽  
Moschen Horacio ◽  
Mendez Martín

Cervical cancer constitutes an issue in public health, becoming the leading cause of death by cancer in women between 20-40 years of age in Latin America. In Argentina 5000 new cases are diagnosed each year, where more than 56% are in advanced stages. The aim of the present current opinion or critical review article is to remark the importance of the prognostic significance of the Central Tumor Size in stages IIB and IIIB cervical cancer, as well as to propose a new FIGO Staging System for Cervical cancer and trying to find out a role for the different therapeutic strategies for those cases.


2021 ◽  
Vol 28 (3) ◽  
pp. 1663-1672
Author(s):  
Satomi Hattori ◽  
Nobuhisa Yoshikawa ◽  
Kazumasa Mogi ◽  
Kosuke Yoshida ◽  
Masato Yoshihara ◽  
...  

(1) This study investigated the prognostic impact of tumor size in patients with metastatic cervical cancer. (2) Methods: Seventy-three cervical cancer patients in our institute were stratified into two groups based on distant metastasis: para-aortic lymph node metastasis alone (IIIC2) or spread to distant visceral organs with or without para-aortic lymph node metastasis (IVB) to identify primary tumor size and concurrent chemoradiotherapy. (3) Results: The overall survival (OS) for patients with a tumor >6.9 cm in size was significantly poorer than that for patients with a tumor ≤6.9 cm in the IVB group (p = 0.0028); the corresponding five-year OS rates in patients with a tumor ≤6.9 and >6.9 cm were 53.3% and 13.4%, respectively. In the multivariate analysis, tumor size and primary treatment were significantly associated with survival in metastatic cervical cancer. (4) Conclusions: Tumor size ≤6.9 cm and concurrent chemoradiotherapy as the primary treatment were favorable prognostic factors for patients with metastatic cervical cancer.


2021 ◽  
Vol 60 (6) ◽  
pp. 1054-1058
Author(s):  
Daiken Osaku ◽  
Hiroaki Komatsu ◽  
Masayo Okawa ◽  
Yuki Iida ◽  
Shinya Sato ◽  
...  

2021 ◽  
Author(s):  
Niloufar Hoorshad ◽  
Narges Zamani ◽  
Shahrzad Sheikh Hasani ◽  
Amirhossein Poopak ◽  
Amirsina Sharifi

Abstract Background: There was an increase in number of patients presented with early-stage cervical cancer (CC). Tumors with favorable pathological features might be candidates for less radical surgery.Methods: We retrospectively reviewed 700 patients with histologically confirmed CC between January 2011 and March 2020. Chi-square, Fisher's exact tests and multivariate logistic regression analysis were used to assess relations between parametrial involvement (PI) and clinic-pathological variables.Results: Total number of 132 patients with stage IA to IIA were eligible to participate. Squamous cell carcinoma was reported in 100 (75.8%) patients, adenocarcinoma and other tumor pathologies were found in 24(18.2%) and 8(6.1%), respectively. Considering the FIGO stage, 11 (8.4%) patients had IA, 111 (83%%) IB and 10 (7.6%) IIA. Nine patients (6.8%) had PI on permanent pathologic report. Univariate analysis demonstrated that following variables were statistically different between patients with and without PI: age ≥ 50, tumor size ≥ 3cm, lower segment involvement, poorly differentiated pathology, deep stromal invasion, pelvic lymph node, lympho-vascular involvement and positive surgical margin (all p values < 0.05). Among these variables only tumor size ≥ 3 cm (OR: 2.1, 95% CI: 1.11-4.16, p value: 0.02), deep stromal invasion (OR: 2.2, 95% CI: 1.9-7.43, p value: 0.02) and positive surgical margin (OR: 5.1, 95% CI: 3.97-11.15, p value: 0.008) were independent risk factor of PI in multivariate analysis.Conclusions: Early stage CC can be surgically approached in a more conservative manner if patients have tumor size < 3 cm and do not have deep stromal invasion in conization.


2018 ◽  
Vol 60 (3) ◽  
pp. 388-395 ◽  
Author(s):  
Jiacheng Song ◽  
Qiming Hu ◽  
Junwen Huang ◽  
Zhanlong Ma ◽  
Ting Chen

Background Detecting normal-sized metastatic pelvic lymph nodes (LNs) in cervical cancers, although difficult, is of vital importance. Purpose To investigate the value of diffusion-weighted-imaging (DWI), tumor size, and LN shape in predicting metastases in normal-sized pelvic LNs in cervical cancers. Material and Methods Pathology confirmed cervical cancer patients with complete magnetic resonance imaging (MRI) were documented from 2011 to 2016. A total of 121 cervical cancer patients showed small pelvic LNs (<5 mm) and 92 showed normal-sized (5–10 mm) pelvic LNs (39 patients with 55 nodes that were histologically metastatic, 53 patients with 71 nodes that were histologically benign). Preoperative clinical and MRI variables were analyzed and compared between the metastatic and benign groups. Results LN apparent diffusion coefficient (ADC) values and short-to-long axis ratios were not significantly different between metastatic and benign normal-sized LNs (0.98 ± 0.15 × 10−3 vs. 1.00 ± 0.18 × 10−3 mm2/s, P = 0.45; 0.65 ± 0.16 vs. 0.64 ± 0.16, P = 0.60, respectively). Tumor ADC value of the metastatic LNs was significantly lower than the benign LNs (0.98 ± 0.12 × 10−3 vs. 1.07 ± 0.21 × 10−3 mm2/s, P = 0.01). Tumor size (height) was significantly higher in the metastatic LN group (27.59 ± 9.18 mm vs. 21.36 ± 10.40 mm, P < 0.00). Spiculated border rate was higher in the metastatic LN group (9 [16.4%] vs. 3 [4.2%], P = 0.03). Tumor (height) combined with tumor ADC value showed the highest area under the curve of 0.702 ( P < 0.00) in detecting metastatic pelvic nodes, with a sensitivity of 59.1% and specificity of 78.8%. Conclusions Tumor DWI combined with tumor height were superior to LN DWI and shape in predicting the metastatic state of normal-sized pelvic LNs in cervical cancer patients.


2021 ◽  
Author(s):  
Yifan Feng ◽  
Ye Wang ◽  
Yangqin Xie ◽  
Shuwei Wu ◽  
Yuyang Li ◽  
...  

Abstract BackgroundThe purpose of this study is to explore the factors that affect the prognosis of overall survival (OS) and cancer special survival (CSS) in cervical cancer with stage IIIC1 and establish nomogram models to predict this prognosis.MethodsData from The Surveil-lance, Epidemiology, and End Results (SEER) Program meeting the inclusion criterions were classified into training group, and data of validation were obtained from the First Affiliated Hospital of Anhui Medical University from 2010 to 2019. The incidence, Kaplan‐Meier curves, OS and CSS of stage IIIC1 were evaluated according to the training group. Nomograms were established according to the results of univariate and multivariate Cox regression models. Harrell’s C-index and receiver operating characteristic curve (ROC) were calculated to measure the accuracy of the prediction models. Calibration plots show the relationship between the predicted probability and the actual outcome. Decision-curve analysis (DCA) was applied to evaluate the clinical applicability of the constructed nomogram.ResultsThe incidence of pelvic lymph node metastasis, a high-risk factor for prognosis in cervical cancer, decreased slightly over time. There are eight independent prognostic variables for OS, including age, race, histology, differentiation, extension range, tumor size, radiation recode and surgery, but seven for CSS with age excluded. Nomograms of OS and CSS were established based on the results. The C-index for the nomograms of OS and CSS were 0.692, 0.689 respectively when random sampling of SEER data sets, and 0.706, 0.737 respectively when random sampling of external data sets. AUCs for the nomogram of OS were 0.648, 0.644 respectively, and 0.683, 0.675 for the nomogram of CSS. Calibration plots for the nomograms were almost identical to the actual observations. The DCA also proved the value of the two models.ConclusionAge, race, histology, differentiation, extension range, tumor size, radiation recode and surgery were all independent prognosis factors for OS. Only age excepts in CSS. OS and CSS nomograms were established in our study based on the result of multivariate Cox proportional hazard regression, and both own good predictive and clinical application value after validation.


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