scholarly journals Recurrence-Free Survival Stage IB1-IIA2 Intermediate Risk Group (Based on Kartu Delgado) Cervical Carcinoma after Radical Surgery and Adjuvant Radiotherapy

2016 ◽  
Author(s):  
Andi Friadi
Keyword(s):  
Prognostic Factor ◽  
Cervical Carcinoma ◽  
Adjuvant Radiotherapy ◽  
Obstet Gynecol ◽  
Radical Surgery ◽  
Early Stage ◽  
Gynecologic Oncology ◽  
Intermediate Risk ◽  
Recurrence Free Survival ◽  
Free Survival

Objective: To evaluate the benefits of adjuvant radiotherapy (ART) based on Kartu Delgado (simple form of Gynecologic Oncology Group (GOG) scoring system) aimed at women with early stage cervical cancer after radical surgery. Method: Fifty patients were enrolled for this study. Twenty one patients from 2011-2012 were given ART following surgery based on their Kartu Delgado score from as follows: score 120 were given ART. Their score and recurrence were compared with 29 patients who were treated in 2009-2010 (based on single prognostic factor). Result: We observed eighteen recurrences for the duration this study. Thirteen patients from the period of 2009-2010 and five patients from the period of 2011-2012. Most recurrences occurred in patients from 2009-2010 with score > 120 but were not designated ART. Two-years recurrence-free survival (RFS) for subjects with score 120 with ART was 64.29%. Conclusion: Adjuvant radiotherapy given based on Kartu Delgado reduced the number of recurrences in women with stage IB-IIA cervical cancer after treated by surgery. [Indones J Obstet Gynecol 2014; 3: 146-152] Keywords: cervical carcinoma, intermediate risk, prognostic factor, radical hysterectomy

Comparison of Radical Surgery and Radiotherapy for the Treatment of Early-Stage Cervical Carcinoma: A Meta-Analysis

2021 ◽  
Vol 44 (4) ◽  
pp. 161-168
Author(s):  
Huixiang Wang ◽  
Chengxiang Ni ◽  
Wei Xiao ◽  
Tonglei Yang ◽  
Wei Sun
Keyword(s):  
Adverse Events ◽  
Cervical Carcinoma ◽  
Large Scale ◽  
Radical Surgery ◽  
Early Stage ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Free Survival ◽  
Hazard Ratios ◽  
Risk Ratios

Objective: To compare the efficacy and safety of radical surgery with radiotherapy in patients with early-stage cervical carcinoma. Methods: PubMed, Web of Science, and Embase were systematically reviewed, and studies comparing radical surgery with radiotherapy were included. The main efficacy outcomes included overall survival (OS), and disease-free survival (DFS). Safety endpoints were adverse events. Hazard ratios (HR) or risk ratios (RR) with 95% CI were used to pool the estimates. Results: A total of 6 studies were included in this meta-analysis. Radical surgery was associated with comparable survival effects in OS (HR = 0.73; 95% CI 0.46–1.17; p = 0.196) and DFS (HR = 0.84; 95% CI 0.64–1.10; p = 0.207) as compared with radiotherapy. Moreover, positive lymphangiography (HR = 3.67; 95% CI 2.86–4.70; p < 0.001), adeno-carcinomatous histotype (HR = 2.53; 95% CI 1.80–3.56; p < 0.001), adenosquamous histotype (HR = 1.55; 95% CI 1.27–1.89; p < 0.001), tumor size ≥4 cm (HR = 1.60; 95% CI 1.14–2.23; p < 0.001), stage IB2 (HR = 1.71; 95% CI 1.43–2.04; p < 0.001), and stage IIA (HR = 1.85; 95% CI 1.54–2.22; p < 0.001) were all independent predictors of decreased survival. Patients treated with radical surgery had a rate of adverse events similar to that of those treated with radiotherapy (RR = 1.23; 95% CI 0.61–2.48; p = 0.557). Conclusion: The present study suggested that radical surgery and radiotherapy offered similarly effective treatment in terms of OS and DFS in early-stage cervical carcinoma. Moreover, the complication rate between the 2 treatments was not significantly different. Considering the potential limitations of this study, more large-scale well-designed randomized controlled trials are needed to verify our findings.

Prognostic Significance of Lymphovascular Space Invasion in the Absence of Lymph Node Metastases in Early-Stage Endometrial Cancer

2018 ◽  
Vol 28 (5) ◽  
pp. 890-894 ◽  
Author(s):  
Ellen Cusano ◽  
Victoria Myers ◽  
Rajiv Samant ◽  
Talia Sudai ◽  
Allison Keller ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Prognostic Factor ◽  
Early Stage ◽  
Prognostic Significance ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Node Negative ◽  
Early Stage Endometrial Cancer ◽  
Lymphovascular Space Invasion

ObjectiveLymphovascular space invasion (LVSI) has been defined as a significant adverse prognostic factor in early-stage endometrial cancer, primarily because of its high association with nodal metastases. This study aimed to determine if LVSI provides any prognostic significance in pathologic node-negative surgically staged (T1N0) endometrial cancer patients.Methods/MaterialsThis retrospective cohort study included all patients with pathologic stage T1N0 endometrial carcinoma treated at The Ottawa Hospital Cancer Centre from 1998 to 2007. Patient demographics, pathologic findings, treatment, and outcome data were collected. Univariate and multivariate cox regression modeling was used to assess significance and adjust for demographic and histopathologic covariates. Kaplan-Meier curves were used to estimate the 5-year overall and recurrence-free survival.ResultsOur study included 400 pathologic stage T1N0 patients who received an initial total hysterectomy and bilateral salpingo-oophorectomy with lymphadenectomy. The median age at diagnosis was 62 years, and the median follow-up was 66 months. Fifty-four patients (13.5%) had a positive LVSI status, and 346 (86.5%) had a negative LVSI status. The 5-year overall survival was 97.3% in patients without LVSI and 90.9% in those with LVSI (P < 0.001). The 5-year recurrence-free survival was 95.2% in patients without LVSI and 85.9% in those with LVSI (P = 0.006). Univariate analysis identified grade, stage, and LVSI as the covariates significantly associated with time to recurrence, and identified age, grade, stage, and LVSI to be significantly associated with overall survival. There were no significant covariates for recurrence-free survival by multivariate analysis, and only age and LVSI were significant for overall survival.ConclusionsLymphovascular space invasion is an overall poor prognostic factor in T1N0 endometrial cancer. After adjusting for other factors, LVSI remains an independent risk factor for worse overall survival. Therefore, estimation of overall survival in patients with early-stage, node-negative endometrial cancer should take into account LVSI status.

Role of radical hysterectomy in patients with early-stage high-grade neuroendocrine cervical carcinoma: a NeCTuR study

2021 ◽  
Vol 31 (4) ◽  
pp. 495-501 ◽  
Author(s):  
Gloria Salvo ◽  
Preetha Ramalingam ◽  
Alejandra Flores Legarreta ◽  
Anuja Jhingran ◽  
Naomi R Gonzales ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Cervical Carcinoma ◽  
Adjuvant Treatment ◽  
Adjuvant Radiotherapy ◽  
Radical Surgery ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
High Grade ◽  
Parametrial Involvement

ObjectivePatients with early-stage, high-grade neuroendocrine cervical carcinoma typically undergo radical hysterectomy with pelvic lymphadenectomy followed by adjuvant radiotherapy and/or chemotherapy. To explore the role of radical surgery in patients with this disease, who have a high likelihood of undergoing postoperative adjuvant therapy, we aimed to determine the rate of parametrial involvement and the rate of parametrial involvement without other indications for adjuvant treatment in these patients.MethodsWe retrospectively studied patients in the Neuroendocrine Cervical Tumor Registry (NeCTuR) at our institution to identify those with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IA1-IB2, high-grade neuroendocrine cervical carcinoma who underwent up-front radical surgery with or without adjuvant therapy.ResultsOne hundred patients met the inclusion criteria. The median age was 35 years (range 22–65), and 51% (51/100) had pure high-grade neuroendocrine carcinoma. No patient had a tumor >4 cm or suspected parametrial or nodal disease before surgery. Ten patients (10%) had microscopic parametrial compromise in the final surgical specimens. Ninety-four (94%) patients underwent nodal assessment, and 19 (19%) had positive nodes. Ten patients underwent both sentinel lymph node biopsy and pelvic lymphadenectomy, and none had false-negative findings. Patients with parametrial compromise were more likely to have positive pelvic nodes (80% vs 12%, p<0.0001), and a positive vaginal margin (20% vs 1%, p=0.03). All patients with parametrial compromise had lymphovascular space invasion (100% vs 73%, p=0.10). Of the 100 patients, 95 (95%) were recommended adjuvant therapy and 89 (89%) were known to have received it. Adjuvant pelvic radiotherapy reduced the likelihood of local recurrence by 62%.ConclusionsIn carefully selected patients with high-grade neuroendocrine cervical carcinoma, the rate of microscopic parametrial involvement is 10%. As most patients receive adjuvant treatment, we hypothesize that simple hysterectomy may be adequate when followed by adjuvant radiotherapy with concurrent cisplatin and etoposide followed by additional chemotherapy.

scholarly journals Histopathologic score predicts recurrence free survival after radical surgery in patients with stage IA2–IB12 cervical carcinoma

Cancer ◽  
2003 ◽  
Vol 97 (8) ◽  
pp. 1904-1908 ◽  
Author(s):  
Dan A. Grisaru ◽  
Allan Covens ◽  
Edmee Franssen ◽  
William Chapman ◽  
Patricia Shaw ◽  
...  
Keyword(s):  
Cervical Carcinoma ◽  
Radical Surgery ◽  
Recurrence Free Survival ◽  
Free Survival

scholarly journals Does Time-to-Chemotherapy after Primary Complete Macroscopic Cytoreductive Surgery Influence Prognosis for Patients with Epithelial Ovarian Cancer? A Study of the FRANCOGYN Group

2021 ◽  
Vol 10 (5) ◽  
pp. 1058
Author(s):  
Grégoire Rocher ◽  
Thomas Gaillard ◽  
Catherine Uzan ◽  
Pierre Collinet ◽  
Pierre-Adrien Bolze ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Retrospective Cohort ◽  
Early Stage ◽  
Cohort Analysis ◽  
Recurrence Free Survival ◽  
Advanced Stage ◽  
Free Survival ◽  
Retrospective Cohort Analysis

To determine if the time-to-chemotherapy (TTC) after primary macroscopic complete cytoreductive surgery (CRS) influences recurrence-free survival (RFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC). We conducted an observational multicenter retrospective cohort analysis of women with EOC treated from September 2006 to November 2016 in nine institutions in France (FRANCOGYN research group) with maintained EOC databases. We included women with EOC (all FIGO stages) who underwent primary complete macroscopic CRS prior to platinum-based adjuvant chemotherapy. Two hundred thirty-three patients were included: 73 (31.3%) in the early-stage group (ESG) (FIGO I-II), and 160 (68.7%) in the advanced-stage group (ASG) (FIGO III-IV). Median TTC was 43 days (36–56). The median OS was 77.2 months (65.9–106.6). OS was lower in the ASG when TTC exceeded 8 weeks (70.5 vs. 59.3 months, p = 0.04). No impact on OS was found when TTC was below or above 6 weeks (78.5 and 66.8 months, respectively, p = 0.25). In the whole population, TTC had no impact on RFS or OS. None of the factors studied were associated with an increase in TTC. Chemotherapy should be initiated as soon as possible after CRS. A TTC greater than 8 weeks is associated with poorer OS in patients with advanced stage EOC.

Adenocarcinoma as an independent risk factor for early-stage intermediate-risk cervical carcinoma

2011 ◽  
Vol 120 ◽  
pp. S104-S105
Author(s):  
C. Mathews ◽  
S. Goodrich ◽  
R. Farrell ◽  
C. DeSimone ◽  
L. Seamon ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cervical Carcinoma ◽  
Independent Risk Factor ◽  
Early Stage ◽  
Intermediate Risk
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