scholarly journals Tumor Histology is an Independent Prognostic Factor in Locally Advanced Cervical Carcinoma. A Retrospective Study

2021 ◽  
Author(s):  
Lenny Gallardo-Alvarado ◽  
David Cantú-de León ◽  
Rebeca Ramirez-Morales ◽  
Gabriel Santiago-Concha ◽  
Salim Barquet-Muñoz ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Cervical Carcinoma ◽  
Cox Model ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Rank Test ◽  
Tumor Histology ◽  
Radiological Staging ◽  
Advanced Cervical Carcinoma ◽  
The Mean

Abstract Background: Even with different histologic origins, squamous cell carcinoma (SCC) and adenocarcinoma (AC) are considered a single entity, and the first-line treatment is the same. Locally advanced disease at the diagnosis of cervical cancer is the most important prognostic factor, the recurrence rate is high, making it necessary to evaluate prognostic factors other than clinical or radiological staging; histology could be one of them but continues to be controversial. The aim of this study was to evaluate tumor histology as a prognostic factor in terms of treatment outcomes, disease-free survival (DFS) and overall survival (OS) in a retrospective cohort of patients with Locally Advanced Cervical Carcinoma (LACC). Methods: The records of 1291patients with LACC were reviewed, all of them were treated with 45-50 Gy of external bean radiotherapy with concurrent chemotherapy and brachytherapy. A descriptive and comparative analysis was conducted. Treatment response was analyzed by the chi-square test; DFS and OS were calculated for each histology with the Kaplan-Meier method and compared with the log-rank test; and the Cox model was applied for the multivariate analysis. Results: We included 1291 patients with LACC treated from 2005 to 2014, of which 1154 (89·4%) had SCC and 137 (10·6%) had AC. Complete response to treatment was achieved in 933 (80·8%) patients with SCC and 113 (82·5%) patients with AC. Recurrence of the disease was reported in 29·9% of SCC patients and 31·9% of AC patients. Five-year DFS was 70% for SCC and 62·2% for AC. The five-year OS rates were 74·3% and 60% for SCC and AC, respectively. The mean DFS was 48·8 months for SCC vs 46·10 for AC (p=0·043), the mean OS was 50·8 for SCC and 47·0 for AC (p=0·002).Conclusion: Our findings support the hypothesis that SCC and AC are different clinical entities. Trial Registration: NCT04537273

Tumor Histology Is an Independent Prognostic Factor in Locally Advanced Cervical Carcinoma

2020 ◽  
Author(s):  
David Francisco Cantu-de León ◽  
Lenny Nadia Gallardo-Alvarado ◽  
Rebeca Ramirez-Morales ◽  
Salim Barquet-Muñoz ◽  
Rosa Salcedo-Hernandez ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Independent Prognostic Factor ◽  
Tumor Histology ◽  
Advanced Cervical Carcinoma

scholarly journals The prognostic value of excission repair cross-complementation group one enzyme expression in locally advanced cervical carcinoma patients treated with cisplatin–based treatment: a meta–analysis

2019 ◽  
Vol 29 (1) ◽  
pp. 35-41
Author(s):  
Jiahao Zhu ◽  
Shengjun Ji ◽  
Qunchao Hu ◽  
Qingqing Chen ◽  
Zhengcao Liu ◽  
...  
Keyword(s):  
Cervical Carcinoma ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Complementation Group ◽  
Enzyme Expression ◽  
Free Survival ◽  
Advanced Cervical Carcinoma ◽  
Platinum Based Chemotherapy ◽  
Disease Free

BackgroundRecently, several studies observed that locally advanced cervical carcinoma with negative excision repair crross-complementation group one enzyme expression has better outcomes in cisplatin-based chemotherapy or chemoradiotherapy than carcinoma with positive excission repair cross-complementation group one enzyme expression. In this meta-analysis, we quantitatively evaluated the prognostic value of excission repair cross-complementation group one enzyme expression in locally advanced cervical carcinoma patients receiving platinum-based chemotherapy or chemoradiotherapy.MaterialsA systematic search for relevant studies was conducted in the PubMed, Cochrane Library, EMBASE and Medline databases. Fixed- or random-effects models were used for pooled analysis. The endpoints were overall survival and disease-free survival () reported as ORs and 95% CIs. The effects of excission repair cross-complementation group one enzyme expression on the clinicopathological parameters were measured by the pooled ORs and their 95% CIs.ResultsEight studies (612 patients in total) satisfied the inclusion criteria. Negative/low excission repair cross-complementation group one enzyme expression was significantly associated with better overall survival (OR, 1.92; 95% CI, 1.22 to 3.05; P = 0.005) and disease-free survival (OR, 5.77; 95% CI, 1.90 to 17.54; P = 0.002). Additionally, there were significant associations between excission repair cross-complementation group one enzyme expression and lymph node metastasis (OR, 2.57; 95% CI, 1.28 to 5.16; P = 0.008).ConclusionsThis meta-analysis suggested that pretreatment excission repair cross-complementation group one enzyme expression might be a useful biomarker to predict prognoses for locally advanced cervical carcinoma patients receiving platinum-based chemotherapy or chemoradiotherapy.

ANALYSIS OF TREATMENT OUTCOMES IN LOCALLY ADVANCED CERVICAL CARCINOMA - AN INSTITUTIONAL STUDY

2021 ◽  
pp. 55-57
Author(s):  
S. Selvalakshmi
Keyword(s):  
Treatment Failure ◽  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Treatment Modalities ◽  
Early Age ◽  
Carcinoma Cervix ◽  
Free Survival ◽  
Screening Programs ◽  
Advanced Cervical Carcinoma

Introduction:Carcinoma cervix is the second most common cancer among women in India. Carcinoma cervix is associated with many risk factors such as multi parity, early age at marriage, early age at coitus and the most important basic cause is poor socioeconomic status, illiteracy, lack of proper self-hygiene, lack of awareness of screening programs and treatment modalities. The main objective of this study is to analyze various outcomes following treatment of locally advanced carcinoma cervix and also to determine the causes of treatment failure so as to improve disease free survival, progression free survival and overall survival. Materials And Methods: A retrospective study was conducted among 191 locally advanced cervical carcinoma patients treated in the Department of Radiotherapy, Stanley Medical College and Hospital, Chennai during the period between 2015 and 2019. Various parameters of our study included age distribution, chief complaints at presentation, histopathological types and grades, staging, type of treatment, details of brachytherapy, response assessment and follow up. Results: Majority of them belong to stage II(50%) followed by stage III (41%). 14 patients belong to stage IV and only 4 patients belong to stage I. Among them 102 patients (53.4%) showed complete response and 34 patients (17.8%) showed partial response. Discussion: Most of the patients were in 4th and 5th decade which is very close to TNCRPregistry. Stage grouping of patients is considered most signicant in assessing the outcome of the treatment wherein it was found necessary to identify and present the symptoms at early stage to fasten the treatment and aim at complete cure. Conclusion: This study brings a clear picture of the possible reasons for treatment failure in locally advanced cervical carcinoma and highlights necessary steps to be implemented in improving infrastructure facilities in Government hospitals that would result in better treatment for poor patients with maximum benets.

Enhanced Radiosensitization with Interferon-α-2b and Cisplatin in the Treatment of Locally Advanced Cervical Carcinoma

1997 ◽  
Vol 67 (3) ◽  
pp. 309-315 ◽  
Author(s):  
Richard G. Stock ◽  
Peter Dottino ◽  
T.Scott Jennings ◽  
Mitchell Terk ◽  
J.Keith Dewyngaert ◽  
...  
Keyword(s):  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Interferon Α ◽  
Advanced Cervical Carcinoma

Audiological findings in a Phase I protocol investigating the effect of WR 2721, high-dose cisplatin and radiation therapy in patients with locally advanced cervical carcinoma

1995 ◽  
Vol 109 (8) ◽  
pp. 744-747 ◽  
Author(s):  
John S. Rubin ◽  
Scott Wadler ◽  
Jonathan J. Baitler ◽  
Hilda Haynes ◽  
Alla Rozenblet ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Phase I ◽  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Hearing Threshold ◽  
High Dose ◽  
High Frequencies ◽  
Advanced Cervical Carcinoma ◽  
Before And After ◽  
Audiologic Testing

AbstractWR 2721 (ethiofos) protects against the toxic effects of the heavy metal compound cisplatin. which is used in the treatment of solid tumours. In a Phase I protocol designed to determine the maximum dose of WR 2721 which could be tolerated when administered in combination with cisplatin and radiation therapy to patients with cervical carcinoma. 11 patients were evaluated by audiologic testing before and after cisplatin WR 2721 administration in an attempt to identify the degree of ototoxicity. Forty-five per cent were noted to have significant hearing threshold changes. predominantly in the high frequencies. There were no significant changes in the speech frequencies in this series. This contrasts with the greater degrees of ototoxicity observed in controls treated in the same way who received cisplatin without WR 2721 protection.

The influence of overall treatment time to the efficiency of chemo-radiotherapy for locally advanced cervical cancer

2017 ◽  
Vol 17 (1) ◽  
pp. 124-130
Author(s):  
Ekkasit Tharavichitkul ◽  
Panupat Rugpong ◽  
Nisa Chawapun ◽  
Razvan M. Galalae
Keyword(s):  
Cervical Cancer ◽  
Treatment Time ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Intracavitary Brachytherapy ◽  
Treatment Results ◽  
Overall Treatment Time ◽  
Free Survival ◽  
Significant Difference ◽  
The Mean

AbstractPurposeThis study aims to clarify the influence of overall treatment time (OTT) on the efficiency of combined chemo-radiotherapy in cervical cancer.Material and methodsThis retrospective study enrolled 122 cervical cancer patients who had squamous cell carcinoma and had undergone definitive chemo-radiotherapy from 2009 to 2013. All patients received whole pelvic radiotherapy (WPRT) with the dose of 50 Gy in 25 fractions (with central shielding after 44 Gy) plus intracavitary brachytherapy with the dose of 28 Gy in four fractions. During WPRT, all patients received concurrent chemotherapy with weekly platinum-based regimen. The data of patient characteristics, OTT, treatment results and toxicities were collected and evaluated.ResultsThe mean follow-up time was 36 months. The mean age of patients was 52 years old; 68% of patients were stage IIB related to International Federation of Gynaecology and Obstetrics staging. Pelvic control (PC), distant metastasis-free survival (DMFS), disease-free survival (DFS) and overall survival (OS) rates did not differ significantly in the data-derived cut points of 55·8 and 53 days. No statistically significant difference in treatment results between the two groups of OTT<49 and OTT≥62 days was observed.ConclusionsIn our data-derived cut point, OTT did not influence to PC, DMFS, DFS and OS. The influence of OTT on treatment results may be found in longer periods.

Five-year overall survival following chemoradiation among HIV-positive and HIV-negative patients with locally advanced cervical carcinoma in a South African cohort

2018 ◽  
Vol 151 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Hannah M. Simonds ◽  
Matthys H. Botha ◽  
Alfred I. Neugut ◽  
Frederick H. Van Der Merwe ◽  
Judith S. Jacobson
Keyword(s):  
Overall Survival ◽  
South African ◽  
Cervical Carcinoma ◽  
Locally Advanced ◽  
Hiv Positive ◽  
Advanced Cervical Carcinoma ◽  
Hiv Negative

Prognostic impact of chemoradiation-related lymphopenia in patients with gastric and gastroesophageal cancer.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 249-249
Author(s):  
Daniel W Kim ◽  
Grace Lee ◽  
Theodore S. Hong ◽  
Guichao Li ◽  
Eric Roeland ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Cox Model ◽  
Gastroesophageal Junction ◽  
Concurrent Chemotherapy ◽  
Rank Test ◽  
Prognostic Impact ◽  
Poor Prognostic Factor ◽  
Risk Of Death ◽  
Increased Risk ◽  
Ecog Ps

249 Background: Limited data exists on how chemoradiation (CRT)-induced lymphopenia affects survival outcomes in patients with gastric and gastroesophageal junction (GEJ) cancer. We evaluated the association between severe lymphopenia and its association with survival in gastric and GEJ cancer patients treated with CRT. We hypothesized that severe lymphopenia would be a poor prognostic factor. Methods: We performed a retrospective analysis of 154 patients with stage 1-3 gastric or GEJ cancer who underwent CRT at our institution. Patients underwent photon-based radiation therapy (RT) with a median dose of 50.4 Gy (IQR 45.0-50.4 Gy) over 28 fractions and concurrent chemotherapy (CTX) with carboplatin/paclitaxel, 5-fluorouracil based regimen, or capecitabine. 49% received CTX prior to RT. 84% underwent surgical resection, 57% pre-CRT and 26% post-CRT. Absolute lymphocyte count (ALC) at baseline and at 2 months since initiating RT were analyzed. Severe lymphopenia, defined as Grade 3 or worse lymphopenia (ALC < 0.5 k/μl), was analyzed for any association with overall survival (OS). Results: Median time of follow up was 48 months. Median age was 65. 77% were male and 86% were Caucasian. ECOG PS was 0 or 1 in 90% and 2 in 10%. Tumor location was stomach in 38% and GEJ in 62%. Timing of CRT was preoperative among 68% and postoperative among 32%. The median ALC at baseline for the entire cohort was 1.6 k/ul (range 0.3-7.0 k/ul). At 2 months post-CRT, 49 (32%) patients had severe lymphopenia. Patients with severe lymphopenia post-CRT had a slightly lower baseline TLC compared to patients without severe lymphopenia (median TLC 1.4 k/ul vs. 1.6 k/ul; p = 0.005). There were no differences in disease and treatment characteristics between the two groups. On the multivariable Cox model, severe lymphopenia post-CRT was significantly associated with increased risk of death (HR = 3.99 [95% CI 1.55-10.28], p = 0.004). ECOG PS 2 (HR = 34.97 [95% CI 2.08-587.73], p = 0.014) and postoperative CRT (HR = 5.55 [95% CI 1.29-23.86], p = 0.021) also predicted worse OS. The 4-year OS among patients with severe lymphopenia was 41% vs. 61% among patients with vs. without severe lymphopenia (log-rank test p = 0.041). Conclusions: Severe lymphopenia significantly correlated with poorer OS in patients with gastric or GEJ cancer treated with CRT. CRT-induced lymphopenia may be an important prognostic factor for survival in this patient population. Closer observation in high-risk patients and treatment modifications may be potential approaches to mitigating CRT-induced lymphopenia.

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