scholarly journals Preoperative SCC-Ag as a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors

2020 ◽  
Author(s):  
Hong-tao Guo ◽  
Xue-han Bi ◽  
Ting Lei ◽  
Xiao Lv ◽  
Guang Yao ◽  
...  

Abstract Background For cervical cancer patients whose tumors display a combination of intermediate risk factors, postoperative radiation with or without adjuvant chemotherapy is suggested for them. However, who should be administered with adjuvant chemotherapy is unknown. The current study was designed to explore the clinical value of squamous cell carcinoma antigen in guiding the use of adjuvant chemotherapy in cervical cancer patients.Methods A retrospective study of 301 cervical cancer patients treated by surgery and adjuvant treatment from Mar. 2005 to Mar. 2015 was performed. All patients were divided into two groups according to receiving adjuvant chemotherapy or not. Overall survival (OS), disease-free survival (DFS) were compare between patients who did and did not receive adjuvant radiotherapy. Multivariate analysis was employed to detect clinical factors associated with disease-free survival, local recurrence-free survival and distant metastasis-free survival.Results For patients with high pre-treatment squamous cell carcinoma level, DFS and OS in adjuvant chemo-radiotherapy group were higher than that in adjuvant radiotherapy group. Besides, the rates of distant metastasis were found lower in patients who did receive adjuvant chemotherapy than those who did not. For patients with upper low pre-treatment squamous cell carcinoma level, the 5-year OS and DFS were similar between groups of adjuvant chemo-radiotherapy and adjuvant radiotherapy. Multivariable analysis indicated adjuvant chemotherapy was independent predictors of DFS and distant metastasis-free survival in patients with high squamous cell carcinoma level.Conclusion Squamous cell carcinoma can serve as an indication for the administration of adjuvant chemotherapy in cervical cancer patients.

2020 ◽  
Author(s):  
Hong-tao Guo ◽  
Xue-han Bi ◽  
Ting Lei ◽  
Xiao Lv ◽  
Guang Yao ◽  
...  

Abstract Background : For cervical cancer patients whose tumors display a combination of intermediate risk factors, postoperative radiation with or without adjuvant chemotherapy is suggested for them. However, who should be administered with adjuvant chemotherapy is unknown. The current study was designed to explore the clinical value of squamous cell carcinoma antigen (SCC-Ag) in guiding the use of adjuvant chemotherapy in cervical cancer patients. Methods : A retrospective study of 301 cervical cancer patients treated by surgery and adjuvant treatment from March 2006 to March 2016 was performed. All patients were divided into two groups according to receiving adjuvant chemotherapy or not. Overall survival (OS), disease-free survival (DFS) were compare between patients who did and did not receive adjuvant radiotherapy. Multivariate analysis was employed to detect clinical factors associated with disease-free survival, local recurrence-free survival and distant metastasis-free survival. Results: For patients with high pre-treatment SCC-Ag level, DFS and OS in adjuvant chemo-radiotherapy group were higher than that in adjuvant radiotherapy group. Besides, the rates of distant metastasis were found lower in patients who did receive adjuvant chemotherapy than those who did not. For patients with low pre-treatment SCC-Ag level, the 5-year OS and DFS were similar between groups of adjuvant chemo-radiotherapy and adjuvant radiotherapy. Multivariable analysis indicated adjuvant chemotherapy was independent predictors of DFS and distant metastasis-free survival (DMFS) in patients with high SCC-Ag level. Conclusion: SCC-Ag can serve as an indication for the administration of adjuvant chemotherapy in cervical cancer patients.


2020 ◽  
Author(s):  
Hong-tao Guo ◽  
Xue-han Bi ◽  
Ting Lei ◽  
Xiao Lv ◽  
Guang Yao ◽  
...  

Abstract Purpose: For cervical cancer patients whose tumors display a combination of intermediate risk factors, postoperative radiation with or without adjuvant chemotherapy is suggested for them. However, who should be administered with adjuvant chemotherapy is unknown. The current study was designed to explore the clinical value of squamous cell carcinoma antigen (SCC-Ag) in guiding the use of adjuvant chemotherapy in cervical cancer patients. Materials and Methods: A retrospective study of 301 cervical cancer patients treated by surgery and adjuvant treatment from March 2006 to March 2016 was performed. All patients were divided into two groups according to receiving adjuvant chemotherapy or not. Overall survival (OS), disease-free survival (DFS) were compare between patients who did and did not receive adjuvant radiotherapy. Multivariate analysis was employed to detect clinical factors associated with disease-free survival, local recurrence-free survival and distant metastasis-free survival. Results: For patients with high pre-treatment SCC-Ag level, DFS and OS in adjuvant chemo-radiotherapy group were higher than that in adjuvant radiotherapy group. Besides, the rates of distant metastasis were found lower in patients who did receive adjuvant chemotherapy than those who did not. For patients with low pre-treatment SCC-Ag level, the 5-year OS and DFS were similar between groups of adjuvant chemo-radiotherapy and adjuvant radiotherapy. Multivariable analysis indicated adjuvant chemotherapy was independent predictors of DFS and distant metastasis-free survival (DMFS) in patients with high SCC-Ag level. Conclusion: SCC-Ag can serve as an indication for the administration of adjuvant chemotherapy in cervical cancer patients.


2007 ◽  
Vol 17 (1) ◽  
pp. 154-158 ◽  
Author(s):  
S. E. Hyde ◽  
S. Valmadre ◽  
N. F. Hacker ◽  
M. S. Schilthuis ◽  
P. T. Grant ◽  
...  

Patients with clinical palpable involved groin lymph nodes and squamous cell cancer of the vulva are frequently treated by a full inguinal-femoral lymph node dissection followed by adjuvant radiotherapy to the groins and pelvis. Theoretically, less radical surgery for the groin such as nodal debulking, where only the macroscopically involved nodes are resected, allowing radiotherapy to treat any remaining microscopic disease may potentially decrease morbidity without compromising survival The objective of this retrospective study was to compare the groin recurrence rate and survival (disease specific and overall survival) of patients with clinically involved groin nodes and squamous cell carcinoma of the vulva treated either by a full inguino-femoral lymphadenectomy or by a nodal debulking followed by radiotherapy. Forty patients from three separate databases who met these criteria were identified. Patients were treated either by a full inguino-femoral lymphadenectomy or by a debulking of the clinically involved inguinal lymph nodes. All patients received adjuvant radiotherapy to the groins. In these two groups, there was no difference in groin recurrence rate expressed as groin recurrence-free survival (P= 0.247). In a univariate analysis, both overall and disease-free survival were better in the group of patients treated by nodal debulking. However, in a multivariate analysis, other variables such as extracapsular growth were independent predictors for survival while the method of surgical dissection for the groin had no independent significant impact on survival.


2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
J Yun ◽  
G Lee ◽  
D Kang ◽  
J Cho ◽  
J Zo ◽  
...  

Abstract   There is limited evidence for effectiveness of adjuvant chemotherapy in esophageal squamous cell carcinoma. We conducted a multi-center randomized controlled trial to assess whether adjuvant Capecitabine and Cisplatin improve survival compared with surgery only among patients with resectable esophageal squamous cell carcinoma. Methods This is a multicenter randomized controlled trials conducted at five hospitals in Korea from Mar 2005 to Dec 2018. Patients were eligible if they underwent curative resection for esophageal squamous cell carcinoma and diagnosed with pathologic T2–3 or N1 stage, according to 6th edition of TNM cancer staging system. Patients who were diagnosed with cervical esophageal cancer, had previous history of cancer, or received neoadjuvant therapy were excluded. Intervention group received 4 cycles of adjuvant chemotherapy (Capecitabine 1,000 mg/m2 b.i.d for 14 days and intravenous Cisplatin 75 mg/m2 at Day1, every 3 weeks). The primary endpoint was disease free survival. Results 136 patients were randomly assigned to adjuvant chemotherapy group (n = 68) or surgery alone group (n = 68). Seven patients who rejected chemotherapy after randomization were excluded from the final analysis. The cumulative incidence of recurrence within 18 months after surgery was significantly lower in the adjuvant chemotherapy group compared to the surgery alone group (Hazard Ratio (HR), 0.45; 95% Confidence Interval (CI), 0.22–0.91). After long-term follow-up (median 3.3 years, maximum 14 years), disease free survival and overall survival were not different between two groups. (HR, 0.77; 95% CI, 0.49–1.18 and HR, 0.85; 95% CI, 0.55–1.34, respectively.) Conclusion Adjuvant chemotherapy after curative resection in patients with esophageal squamous cell carcinoma reduced early recurrence but this does not extend to long-term disease free and overall survival due to limited sample size. Additional randomized controlled trials with larger sample would be necessary to confirm the effectiveness of adjuvant chemotherapy in esophageal squamous cell carcinoma.


2003 ◽  
Vol 21 (24) ◽  
pp. 4592-4596 ◽  
Author(s):  
Nobutoshi Ando ◽  
Toshifumi Iizuka ◽  
Hiroko Ide ◽  
Kaoru Ishida ◽  
Masayuki Shinoda ◽  
...  

Purpose: We performed a multicenter randomized controlled trial to determine whether postoperative adjuvant chemotherapy improves outcome in patients with esophageal squamous cell carcinoma undergoing radical surgery. Patients and Methods: Patients undergoing transthoracic esophagectomy with lymphadenectomy between July 1992 and January 1997 at 17 institutions were randomly assigned to receive surgery alone or surgery plus chemotherapy including two courses of cisplatin (80 mg/m2 of body-surface area × 1 day) and fluorouracil (800 mg/m2 × 5 days) within 2 months after surgery. Adaptive stratification factors were institution and lymph node status (pN0 versus pN1). The primary end point was disease-free survival. Results: Of the 242 patients, 122 were assigned to surgery alone, and 120 to surgery plus chemotherapy. In the surgery plus chemotherapy group, 91 patients (75%) received both full courses of chemotherapy; grade 3 or 4 hematologic or nonhematologic toxicities were limited. The 5-year disease-free survival rate was 45% with surgery alone, and 55% with surgery plus chemotherapy (one-sided log-rank, P = .037). The 5-year overall survival rate was 52% and 61%, respectively (P = .13). Risk reduction by postoperative chemotherapy was remarkable in the subgroup with lymph node metastasis. Conclusion: Postoperative adjuvant chemotherapy with cisplatin and fluorouracil is better able to prevent relapse in patients with esophageal cancer than surgery alone.


2019 ◽  
Vol 37 (4) ◽  
pp. 175-180
Author(s):  
Nasrin Hossain ◽  
Rahana Perveen ◽  
Mohammed Sharif Mahmud ◽  
Mohammed Kabirul Hassan

Introduction: Cervical cancer is the fourth most common cancer in women worldwidev . Most patients in developing countries including Bangladesh present at advanced stage. Histopathological types of cervical cancer influence the treatment outcome when treated by radiation therapy. Objective: To determine the disease free survival (DFS) in different histopathological types in advanced stage cervical carcinoma treated with radiotherapy. Methods: A prospective cohort study was conducted in Gynaecological oncology outpatient department (GOPD) of National institute of Cancer Research & Hospital (NICRH), Dhaka for one year from September’2016 to July’2017. Advanced stage (IIB-IVB) cervical cancer who completed radiation therapy and histopathological type either squamous cell carcinoma or adenocarcinoma of cervix were included in this study. Results: The median follow-up time was 1.82 years; range was 8 to 24 months. Average disease free survival (DFS) was 1.53years in squamous cell carcinoma (SSC) and 1.51 years in adenocarcinoma (ADC). Local recurrences was higher in adenocarcinoma group (62.5%) than squamous cell carcinoma (30.5%) & the difference was statistically significant (p = 0.001). Loco-regional recurrence and distal recurrence were also higher in ADC than SSC but results were not statistically significant (p=.345, p=.795). In multivariate analysis it was shown that histopathological type and stage of disease were found to be independently significant prognostic factors for DFS, hazard ratio were 1.766 (p=.018) and 2.173 (p=.006). Conclusion: Adenocarcinoma was a poor prognostic factor for patients with locally advanced cervical carcinoma. Advanced stage of disease was also significant predictor for disease free survival. J Bangladesh Coll Phys Surg 2019; 37(4): 175-180


2020 ◽  
Vol 61 (2) ◽  
pp. 221-230
Author(s):  
Keiichi Tanaka ◽  
Yoshitaka Matsumoto ◽  
Hitoshi Ishikawa ◽  
Nobuyoshi Fukumitsu ◽  
Haruko Numajiri ◽  
...  

Abstract The Rho-associated coiled-coil-containing protein kinase (ROCK) pathway is known to influence metastasis in several cancers; however, the impact of the pathway on clinical outcomes in patients undergoing radiotherapy remains unknown. In the present study, the expression of RhoA, RhoC, ROCK-1, ROCK-2 and p53 was immunohistochemically evaluated using biopsy specimens obtained from 49 patients with stage II–III cervical squamous cell carcinoma treated with concurrent chemoradiotherapy (CCRT). The relationship between the expression of these proteins and patient outcomes was investigated. RhoA overexpression was associated with significantly impaired disease-free survival and distant metastasis-free survival (P = 0.045 and P = 0.041, respectively) in stage III cancer patients. No differences in survival were observed based on the expression of the other proteins among stage III cancer patients. In stage II cancer patients, no differences in survival were noted based on the expression of any of the proteins. The expression of RhoA was able to successfully differentiate cervical cancer patients with distant metastasis after CCRT. This information may help stratify patients according to the risk of metastasis, thereby leading to the potential to provide individualized treatment.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Danielle R. L. Brogden ◽  
Christopher C. Khoo ◽  
Christos Kontovounisios ◽  
Gianluca Pellino ◽  
Irene Chong ◽  
...  

AbstractAnal Squamous Cell Carcinoma (ASCC) is a rare cancer that has a rapidly increasing incidence in areas with highly developed economies. ASCC is strongly associated with HIV and there appears to be increasing numbers of younger male persons living with HIV (PLWH) diagnosed with ASCC. This is a retrospective cohort study of HIV positive and HIV negative patients diagnosed with primary ASCC between January 2000 and January 2020 in a demographic group with high prevalence rates of HIV. One Hundred and seventy six patients were included, and clinical data was retrieved from multiple, prospective databases. A clinical subgroup was identified in this cohort of younger HIV positive males who were more likely to have had a prior diagnosis of Anal Intraepithelial Neoplasia (AIN). Gender and HIV status had no effect on staging or disease-free survival. PLWH were more likely to develop a recurrence (p < 0.000) but had a longer time to recurrence than HIV negative patients, however this was not statistically significant (46.1 months vs. 17.5 months; p = 0.077). Patients known to have a previous diagnosis of AIN were more likely to have earlier staging and local tumour excision. Five-year Disease-Free Survival was associated with tumour size and the absence of nodal or metastatic disease (p < 0.000).


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