scholarly journals Postoperative survival and functional outcomes for patients with metastatic gynecological cancer to the spine: case series and review of the literature

2016 ◽  
Vol 24 (1) ◽  
pp. 131-144 ◽  
Author(s):  
Ann Liu ◽  
Eric W. Sankey ◽  
C. Rory Goodwin ◽  
Thomas A. Kosztowski ◽  
Benjamin D. Elder ◽  
...  

OBJECT Spinal metastases from gynecological cancers are rare, with few cases reported in the literature. In this study, the authors examine a series of patients with spinal metastases from gynecological cancer and review the literature. METHODS The cases of 6 consecutive patients who underwent spine surgery for metastatic gynecological cancer between 2007 and 2012 at a single institution were retrospectively reviewed. The recorded demographic, operative, and postoperative factors were reviewed, and the functional outcomes were determined by change in Karnofsky Performance Scale and the American Spine Injury Association (ASIA) score during follow-up. A systematic review of the literature was also performed to evaluate outcomes for patients with similar gynecological metastases to the spine. RESULTS In this series, details regarding metastatic gynecological cancers to the spine are as follows: 2 patients with cervical cancer (both presented at age 46 years, mean postoperative survival of 32 months), 2 patients with endometrial cancer (mean age of 40 years, mean postoperative survival of 26 months), and 2 patients with leiomyosarcoma (mean age of 44 years, mean postoperative survival of 20 months). All patients presented with pain, and no complications were noted following surgery. All patients with known follow-up had stable or improved neurological outcomes, performance status, and improved pain, without local recurrence of tumor. Overall median survival after diagnosis of metastatic spine lesions for all cases in the literature as well as those treated by the authors was 15 months. When categorized by type, median survival of patients with cervical cancer (n = 2), endometrial cancer (n = 26), and leiomyosarcoma (n = 16) was 32, 10, and 22.5 months, respectively. CONCLUSIONS Gynecological cancers metastasizing to the spine are rare. In this series, overall survival following diagnosis of spinal metastasis and surgery was 27 months, with cervical cancer, endometrial cancer, and leiomyosarcoma survival being 32, 26, and 20 months, respectively. Combined with literature cases, survival differs depending on primary histology, with decreasing survival from cervical cancer (32 months) to leiomyosarcoma (22.5 months) to endometrial cancer (10 months). Integrating such information with other patient factors may more accurately guide decision making regarding management of such spinal lesions.

2005 ◽  
Vol 15 (3) ◽  
pp. 413-419 ◽  
Author(s):  
F. M. Kew ◽  
A. P. Roberts ◽  
D. J. Cruickshank

The objective of this article was to determine the evidence base for routine follow-up after gynecological malignancy. Only articles with a survival analysis were included. Relevant articles were identified by a comprehensive literature search of the main biomedical databases, hand searching of references of selected articles, and expert spotting of relevant journals and proceedings of international meetings. A two-stage extraction of data was undertaken. No prospective trials were identified. Twenty-nine retrospective case series analyses and one poster presentation met the inclusion criteria. Eight articles and one letter on endometrial cancer, six articles and one poster presentation on cervical cancer, and two articles in vulval cancer were reviewed. Only one article in endometrial cancer showed any survival benefit from routine follow-up, but it was of very poor methodologic quality. Two articles found a survival benefit from routine follow-up after cervical cancer. The two articles on vulval cancer did not find any survival benefit from routine review. There is no prospective research on the benefits of routine follow-up after gynecological cancer. Retrospective evidence calls in to question the benefit of universal follow-up. Prospective research is urgently needed.


2020 ◽  
Vol 23 (7) ◽  
pp. 434-444
Author(s):  
Sahar Eftekharzadeh ◽  
Narges Ebrahimi ◽  
Mehrnoosh Samaei ◽  
Farnam Mohebi ◽  
Bahram Mohajer ◽  
...  

Background: The present study aims to assess the incidence and mortality rates of gynecological cancers and their changes from 1990 to 2016 at national and subnational levels in Iran. Methods: Annual estimates of incidence and mortality for gynecological cancers from 1990 to 2016 at national and subnational levels were generated as part of a larger project entitled National and Subnational Burden of Diseases, Injuries, and Risk Factors (NASBOD). After the precise processing of data extracted from the Iran Cancer Registry, annual age-standardized incidence and mortality rates were calculated for each cancer, province, year and age group during the period of the study. Results: In 2016, gynecological cancers constituted 8.0% of new cancer cases among women of all ages compared to 3.7% of new cases of cancer among women in 1990. The incidence rate of gynecological cancers has increased from 2.5 (0.9-5.6) per 100000 women in 1990 to 12.3 (9.3–15.7) per 100000 women in 2016, and the most common gynecological cancer has changed from cervical cancer in 1990 to corpus uteri cancer in 2016. Age-standardized incidence rates of ovarian, corpus uteri and vulvovaginal cancers increased from 1.3 (0.5–2.4), 1.7 (0.6–3.0), and 0.3 (0.0–0.7) in 1990 to 4.4 (3.6–5.2), 9.9 (6.8–13.4), and 0.6 (0.2–1.0) in 2016, respectively, showing a 3.3, 5.8 and 1.7-fold increase during this period. Age-standardized incidence rate of cervical cancer was 2.4 (1.7–3.3) cases per 100000 women in 2016 and did not differ significantly from the beginning of the study. An overall reduction was seen in national mortality to incidence ratios (MIR) from 2000 to 2015. Conclusion: The incidence rates of all gynecological cancers in different provinces have shown a converging trend that could indicate that attempts toward health equality have been effective. The declining trend of MIR could be interpreted as advancements in detection of cancer in its early stages and also improvements in treatments, in turn reflecting improvements in access to and quality of care.


2017 ◽  
Vol 27 (8S) ◽  
pp. S1-S9 ◽  
Author(s):  
Murat Gultekin ◽  
Irem Kucukyildiz ◽  
Mujdegul Zayifoglu Karaca ◽  
Selin Dundar ◽  
Guledal Boztas ◽  
...  

ObjectiveThe aim of this study was to evaluate nationwide gynecological cancer trends in Turkey.MethodsNational cancer registry data (2009–2013) of Turkish Ministry of Health were evaluated. Ovarian, cervical, endometrial, vulvar, vaginal, and tubal cancers are evaluated with respect to age of diagnosis, incidence rates within years, stage, histological distributions, and mortality rates. Data were collected from active cancer registry centers, which increased from 23% in 2009 to 47.5% coverage of the whole population by 2012, and mortality data (2010–2015) were obtained from the Turkish Statistical Institute.ResultsA total of 16,023 gynecological cancers were evaluated among 116,940 female patients with cancer (13.7%). Average incidence for gynecological cancers was 22.7 of 100,000, representing 8437 total new cases annually. Incidence changes within time were not statistically significant, when evaluated for each tumor type. Estimated risk of gynecological cancer development before the age of 80 years was 3.08% (95% confidence interval, 3.07–3.09). The most common gynecological cancers were uterine corpus cancers, which were followed by ovarian and cervical carcinomas. Ovarian and uterine cancer incidences were closer to European levels rather than Asian countries, whereas cervical cancer incidence was extremely low. Gynecological cancers constituted an important fraction of cancer-related mortality in women by comprising approximately 10.35% of cancer-related deaths. Mortality rates due to gynecological cancers did not show a statistically significant increase within years.ConclusionsThis is the first national cancer registry report to be published for gynecological cancers by the Turkish Governmental Department. As a result, Turkish gynecological cancer epidemiological data were consistent with the data obtained from European and developed countries rather than Asian countries, except for cervical cancer incidence, which is extremely low.


2002 ◽  
Vol 227 (8) ◽  
pp. 579-586 ◽  
Author(s):  
Roman Miturski ◽  
Michał Bogusiewicz ◽  
Carmella Ciotta ◽  
Margherita Bignami ◽  
Marek Gogacz ◽  
...  

Due to major developments in genetics over the past decade, molecular biology tests are serving promising tools in early diagnosis and follow-up of cancer patients. Recent epidemiological studies revealed that the risk for each individual to develop cancer is closely linked to his/her own genetic potentialities. Some populations that are defective in DNA repair processes, for example in Xeroderma pigmentosum or in the Lynch syndrome, are particularly prone to cancer due to the accumulation of mutations within the genome. Such populations would benefit from the development of tests aimed at identifying people who are particularly at risk. Here, we review some data suggesting that the inactivation of mismatch repair is often found in endometrial cancer and we discuss molecular-based strategies that would help to identify the affected individuals in families with cases of glandular malignancies.


2017 ◽  
Vol 27 (7) ◽  
pp. 1525-1533 ◽  
Author(s):  
Murat Gultekin ◽  
Irem Kucukyildiz ◽  
Mujdegul Zayifoglu Karaca ◽  
Selin Dundar ◽  
Guledal Boztas ◽  
...  

ObjectiveThe aim of this study was to evaluate nationwide gynecological cancer trends in Turkey.MethodsNational cancer registry data (2009–2013) of Turkish Ministry of Health were evaluated. Ovarian, cervical, endometrial, vulvar, vaginal, and tubal cancers are evaluated with respect to age of diagnosis, incidence rates within years, stage, histological distributions, and mortality rates. Data were collected from active cancer registry centers, which increased from 23% in 2009 to 47.5% coverage of the whole population by 2012, and mortality data (2010–2015) were obtained from the Turkish Statistical Institute.ResultsA total of 16,023 gynecological cancers were evaluated among 116,940 female patients with cancer (13.7%). Average incidence for gynecological cancers was 22.7 of 100,000, representing 8437 total new cases annually. Incidence changes within time were not statistically significant, when evaluated for each tumor type. Estimated risk of gynecological cancer development before the age of 80 years was 3.08% (95% confidence interval, 3.07–3.09). The most common gynecological cancers were uterine corpus cancers, which were followed by ovarian and cervical carcinomas. Ovarian and uterine cancer incidences were closer to European levels rather than Asian countries, whereas cervical cancer incidence was extremely low. Gynecological cancers constituted an important fraction of cancer-related mortality in women by comprising approximately 10.35% of cancer-related deaths. Mortality rates due to gynecological cancers did not show a statistically significant increase within years.ConclusionsThis is the first national cancer registry report to be published for gynecological cancers by the Turkish Governmental Department. As a result, Turkish gynecological cancer epidemiological data were consistent with the data obtained from European and developed countries rather than Asian countries, except for cervical cancer incidence, which is extremely low.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23180-e23180 ◽  
Author(s):  
Rachel Isaksson Vogel ◽  
Patricia Jewett ◽  
Audrey Messelt ◽  
Heewon Lee ◽  
Susan Everson-Rose ◽  
...  

e23180 Background: Psychosocial outcomes have been described in women with gynecological cancers, but potential differences by diagnosis have received less attention. We sought to compare quality of life (QOL) and emotional health among early stage gynecological cancer survivors by disease location. Methods: We present baseline data from an ongoing cohort study of gynecological cancer patients treated at an academic cancer center. Measures include cancer-related QOL, emotional health and negative (post-traumatic stress disorder-PTSD) and positive (post-traumatic growth-PTG) reactions to cancer. Univariate and multivariate linear regression models (restricted to stage I or II; excluding vaginal/vulvar) explored differences in QOL and emotional health by diagnosis. Potential confounders considered for inclusion in the final models were age, stage, education, income, partner status, treatment status, and race. Results: 222 patients with early stage disease completed the survey: 56 (25.2%) ovarian, 122 (55.5) endometrial, 33 cervical (14.9%), and 11 (5%) vaginal/vulvar cancer. Cervical and vaginal/vulvar cancer patients reported greater cancer-related distress, anxiety and PTSD scores (Table). Endometrial cancer patients reported lowest PTG scores. Conclusions: Our analyses suggest early stage gynecological cancer patients face different psychosocial sequelae based on diagnosis, with worse outcomes generally being associated with younger age. Further research is needed to assess low PTG among endometrial cancer patients, since PTG is considered a potentially beneficial psychosocial outcome of cancer. [Table: see text]


2016 ◽  
Vol 10 (2) ◽  
pp. 24-28
Author(s):  
R Joshi ◽  
G Baral ◽  
K Malla

Aims: The incidence of cancer and the cancer related deaths are increasing worldwide. There is limited data regarding  gynecological cancers in Nepal. This study is conducted to analyze the trends of female genital tract malignancies in Paropakar Maternity and Women’s Hospital (PMWH) and compare it with the national/international data.Methods: This was a retrospective study conducted in Department of Obstetrics/Gynecology and Pathology in PMWH.  All female diagnosed with the genital tract malignancies from July 2013 to July 2015 were included in the study.Results: Among 62 cases, cervical cancer was the commonest (71%) followed by ovarian cancer (14%), endometrial cancer (8%) and choriocarcinoma (3%). Majority of women belonged to 50-59 years for each type of tumors. Four-fifth of endometrial, half of the cervical and one-third of ovarian cancers were among grand-multipara. Sixty nine percent of women received treatment with 22 (9 cervical, 9 ovarian, 3 endometrial and one of corpus uteri)  surgical and 21 primary chemo/radiotherapy but 19 (31%) were lost for follow-up. Squamous type of cervical cancer was the commonest (93%).Conclusions: Cervical cancer was the commonest genital tract malignancy followed by ovarian cancer, endometrial cancer and choriocarcinoma. For each type of tumors, 50-59 years was the common age group and grand multiparity was seen in half of the women with the cervical cancer. Squamous type of cervical cancer was the commonest variety.  


2007 ◽  
Vol 17 (5) ◽  
pp. 1155-1159 ◽  
Author(s):  
A. Baloglu ◽  
D. Uysal ◽  
N. Aslan ◽  
S. Yigit

The objective of this study is to review the implantation of malignant cells of cervical cancer in an episiotomy site. This is the second case of cervical cancer with concomitant episiotomy metastasis in the literature. The treatment consisted of radiochemotherapy. There was no confirmed recurrent disease after 1 year of follow-up in our reported case. In conclusion, pregnancy appears to be a chance for cervical cancer screening as a part of prenatal care. If cervical cancer is diagnosed in a woman after vaginal delivery, she must be examined carefully including the episiotomy site.


2020 ◽  
Vol 30 (8) ◽  
pp. 1177-1182
Author(s):  
Sarah Coleridge ◽  
Jo Morrison

ObjectiveRecurrence of low-risk endometrioid endometrial cancer is rare, and traditional hospital follow-up has a cost to both the patient and the healthcare system, without evidence of benefit. We examined the uptake of patient-initiated follow-up, pattern of recurrences, and survival for women following surgical treatment of low-risk endometrial cancer and compared estimated costs with hospital follow-up.MethodsThis study was a prospective audit of outcomes following implementation of a patient-initiated follow-up policy in a UK-based gynecological cancer center for women with low-risk endometrial cancer treated surgically (International Federation of Gynecology and Obstetrics (FIGO) stage 1A, G1-2) from January 2010 to December 2015. Women were identified following multidisciplinary team meetings and data were collected from the electronic cancer register, paper, and electronic clinical records. Health service costs were calculated based on standard tariffs for follow-up appointments; patient costs were estimated from mileage traveled from home postcode and parking charges. Progression-free survival and overall survival were assessed. Estimated financial costs to the health service and patients of hospital follow-up were compared with actual patient-initiated follow-up costs.ResultsA total of 129 women were offered patient-initiated follow-up (declined by four; accepted by another 11 after hospital follow-up for 6 months to 3.5 years) with median follow-up of 60.7 months (range 1.4–109.1 months). Ten women recurred: four vaginal vault recurrences (all salvaged), three pelvic recurrences (all salvaged), and three distant metastatic disease (all died). Five-year disease-specific survival was 97.3%. Ten women in the cohort died: three from endometrial cancer and seven from unrelated causes. The cost saving to the health service of patient-initiated follow-up compared with a traditional hospital follow-up regimen was £116 403 (median £988.60 per patient,range £0–£1071). Patients saved an estimated £7122 in transport and parking costs (median £57.22 per patient,range £4.98–£147.70).ConclusionPatient-initiated follow-up for low risk endometrial cancer has cost benefits to both health service and patients. Those with pelvic or vault recurrence had salvageable disease, despite patient-initiated follow-up.


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